Therapeutic phlebotomy

Understanding Therapeutic Phlebotomy

Therapeutic phlebotomy is a medical procedure used to manage specific conditions, particularly blood disorders that cause elevated iron levels. By removing red blood cells, the treatment helps reduce excess iron in the body. While iron is essential for various bodily functions, an excess can be harmful, potentially leading to serious health issues such as liver damage, irregular heart rhythms, and diabetes.

Your healthcare provider may advise therapeutic phlebotomy if you have:

• Hemochromatosis, a disease that causes high iron levels
• Sickle cell disease
• Non-alcoholic fatty liver disease
• Porphyria cutanea tarda, a rare blood disorder that causes blisters to form when the skin is exposed to sunlight
• A higher concentration of red blood cells after a kidney transplant that is not controlled in other ways

Therapeutic phlebotomy can also help treat polycythemia vera, a rare type of blood cancer that causes the bone marrow to make too many red blood cells making the blood too thick. This thickening of the blood can lead to heart disease, blood clots, and other problems.

What to expect during therapeutic phlebotomy

The procedure may be done weekly, monthly, or less often, depending on your condition. Your healthcare provider will decide how often you need it done and how much blood will be taken each time. You will also need regular blood tests to check your iron and red blood cell levels.

It is best to drink lots of fluids and eat a good meal a few hours before therapeutic phlebotomy.

Do not drink alcohol 24 hours beforehand.

The procedure takes about 1 hour. During the procedure:

• You will be seated or lying down.
• Your healthcare provider checks your pulse, blood pressure, and overall health.
• Your provider puts a needle in a vein in your arm. Blood goes from the needle through a tube into a bag.
• Your healthcare provider collects a unit of blood (500 mL) or more, as advised by your treatment plan. Each pint of blood is replaced with fluids, either through your vein or by mouth, during the procedure.
• Once enough blood is collected, the healthcare provider takes out the needle.
• The blood is usually discarded.

What happens after therapeutic phlebotomy?

After the procedure, your healthcare provider will ask you to stay for at least 15 minutes. You may be given something to eat and drink. Over the next 4 hours, drink more fluids than usual. If there is bleeding from the site of the blood draw, raise your arm and apply pressure to the area.

Your healthcare provider may also advise that you:

• Do not smoke for at least 1 hour.
• Do not drink alcohol after the procedure until you have eaten.
• Do not use heavy machinery or stand on a high surface, such as a ladder, right after the procedure.
• Do not do any strenuous activity for 24 hours.

Possible Risks

• Nausea
• Vomiting
• Dizziness
• Fainting
• Bruising at the site
• Seizures
• Infection

Care after treatment

Call your healthcare provider right away if you have any of these symptoms:

• Fever of 100.4°F (38°C) or higher, or as advised by your provider
• Bleeding that doesn’t stop from the site of the blood draw
• Symptoms that don’t get better, or get worse
• New symptoms