Transfusion medicine handbook

9. Other Services Provided by NZBS

9.2 Therapeutic Venesection

Whole blood therapeutic venesection is available for patients with medical conditions where regular venesection is beneficial such as haemochromatosis, polycythaemia and porphyria cutanea tarda.

Blood collected from an individual with genetic haemochromatosis may potentially be used to prepare therapeutic blood components and fractionated products if the patient meets all normal donor selection criteria and is registered as a blood donor. See Section 2.7: Haemochromatosis for further information.

In the case of polycythaemia vera managed by venesection in combination with cytoreductive medication, the referring doctor remains responsible for the management of the patient’s underlying condition and should regularly review the patient (at least every 12 weeks), as well as providing instructions concerning the frequency of venesection. NZBS is responsible for venesection and ensuring the safety of the patient during the procedure. It is not possible to prepare therapeutic blood components and fractionated products from patients with polycythaemia vera.

For patients with polycythaemia managed by venesection alone, and following clear instruction from the referring doctor, it may be possible for NZBS to monitor the haematocrit and adjust the frequency of venesection accordingly. In such cases, review by the referring doctor at intervals greater than 12 weeks may be appropriate.

A similar arrangement for the monitoring of ferritin levels and titration of therapeutic venesection may be made for patients with porphyria cutanea tarda.