Understanding Therapeutic Phlebotomy

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Therapeutic phlebotomy is done to treat certain diseases. It’s often used to treat blood disorders that raise iron levels in the body. The procedure removes red blood cells, causing iron levels to drop. Iron is a mineral your body needs. But too much of it can lead to problems such as liver failure, an irregular heartbeat, and diabetes.

Your healthcare provider may advise this procedure 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's not controlled in other ways

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

Therapeutic phlebotomy may be done weekly, monthly, or less often. It depends 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’s best to drink lots of fluids and eat a good meal a few hours before therapeutic phlebotomy. Don’t drink alcohol 24 hours beforehand.

The procedure takes about 1 hour. During it:

• You sit or lie down.
• A healthcare provider checks your pulse, blood pressure, and overall health.
• The healthcare provider puts a needle in a vein in your arm. Blood goes from the needle through a tube into a bag.
• The 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.

After the procedure, the 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.

The healthcare provider may also advise that you:

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

This procedure has the same possible risks as donating blood. These are:

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

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

• 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