Department of Pathology, Anatomy, & Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Transfusion. 2021 Mar;61(3):673-677. doi: 10.1111/trf.16308. Epub 2021 Feb 13.
Therapeutic phlebotomy (TP) is a well-established medical intervention that evolved from the historical practice of bloodletting.
Patients who require TP are not infrequently told by their health-care providers to "just go donate blood," but TP should always be offered in the context of a prescribed course of therapy. Providers can prescribe a course of TP for a number of indications, including hereditary hemochromatosis, polycythemia vera, iron overload, and testosterone replacement therapy.
A course of prescribed TP specifies that patients can be phlebotomized more frequently than volunteer blood donors and reassures patients that TP is being performed per the orders of their provider. Prescribed TP also facilitates two-way communication between the referring provider and the transfusion medicine (TM) physician overseeing the TP. The College of American Pathologists TM checklist describes several requirements regarding the documentation and performance of TP, and electronic medical record systems can be used to demonstrate compliance with these requirements.
TM physicians should discuss the advantages of prescribing TP with providers who mutually care for patients requiring this intervention.
治疗性放血（TP）是一种成熟的医学干预手段，源于历史上的放血疗法。
需要进行 TP 的患者经常被其医疗保健提供者告知“只需去献血”，但 TP 应始终在规定的治疗方案背景下提供。提供者可以为多种适应症开 TP 治疗方案，包括遗传性血色素沉着症、真性红细胞增多症、铁过载和睾酮替代治疗。
规定的 TP 治疗方案规定，患者可以比自愿献血者更频繁地接受放血，并向患者保证 TP 是根据其提供者的医嘱进行的。规定的 TP 还促进了转诊提供者和监督 TP 的输血医学（TM）医生之间的双向沟通。美国病理学家学院（College of American Pathologists）的 TM 检查表描述了关于 TP 记录和执行的若干要求，电子病历系统可用于证明符合这些要求。
TM 医生应与共同照顾需要这种干预的患者的提供者讨论开具 TP 的优势。
