Therapeutic Phlebotomy

Therapeutic phlebotomy is a procedure to withdraw extra blood in order to decrease iron overload in the body. This iron overload may be hereditary like in haemochromatosis or acquired due to chronic transfusions, to remove abnormal shaped red blood cells like in sickle cell anemia or to decrease the viscosity of blood due to increased red cell mass called as polycythemia. 

Symptoms of Polycythemia

Polycythemia may be primary that is increase in red cell count without any other disease like in polycythemia vera or secondary occurring in response to other disease like COPD, cyanotic congenital heart diseases or others. This increase in hemoglobin can lead to clinical sign and symptoms of increased viscosity like fatigue, headache, muscle aches, visual disturbances, difficulty in breathing, bleeding problems and rarely stroke. Many of these symptoms can be controlled by periodically removing blood from the body with therapeutic phlebotomy technique.

During therapeutic phlebotomy about 450 to 500 ml of patient’s blood is withdrawn. This leads to decrease in viscosity and hence relief from above mentioned symptoms. Therapeutic phlebotomy may be repeated at intervals of 15 days or less depending on the relief from symptoms. 4 to 6 sessions of phlebotomy can be performed and can be repeated after 6 months or as and when required if the primary cause for iron overload or polycythemia is not resolved. Patient should be well hydrated before starting therapeutic phlebotomy. This can be performed as an Indoor procedure or on OPD basis. 

Usually there is no need to replace IV fluids when only one unit is withdrawn and oral hydration will suffice. It takes about 1 to 1.5 hours from the time patient comes and leaves. The patient is offered light refreshments after the procedure to keep him or her under observation for few minutes. He or she is advised to have more fluids for next 1 or 2 days and avoid strenuous activity for next 24 hours.

Side effects of therapeutic phlebotomy

There are no side effects or risk of acquiring any blood-borne infections from therapeutic phlebotomy. In rare cases, the patient may feel dizzy or lightheaded which is easily manageable. 

We at Blood bank, Paras Hospitals, Panchkula are fully equipped to perform therapeutic phlebotomy.