Therapeutic phlebotomy

[KidneyBham]

Hi, I got a call today from my transplant team because my hematocrit was high, they want to do a therapeutic phlebotomy next week, they said it’s like giving blood meaning my body is making to much blood and they need to remove some. Anyone ever had this done, I’m 2 years post transplant.

[Frida2013]

Hi , I have also been diagnosed with high hematocrit and have been waiting 4 weeks to have venesection, everything is taking longer due to the pandemic( I’m in the UK )I have been told it’s because my blood has high amounts of red blood cells, I’m 8 years post transplant and my hematocrit has been steadily increasing .

[Lionkin]

Hello KidneyBham, I had phlebotomy done in July after 13 month after KTR, reason my Hemotocrit = 59, The phlebotomy helped improve the numbers by 10%, which prevents build of blood clots. I am told - it seems the native kidneys are generating EPO which is triggering the creation of excess RBC and hence high hematocrit & Hemoglobin. yes get it done. I had an ultrasound done too, & it is confirmed that my native kidneys are in a state of atrophy.

[KidneyBham in reply to Lionkin]

What do u mean when u say your kidney

Is in a state of atrophy

[Lionkin in reply to KidneyBham]

In my earlier reply: Atrophy is referred to the native Kidneys or in other words the Old 2 kidneys (not applicable to the new transplated kidney) Atrophy means that flow of blood thru' the old kidneys is minimal and as the kidney shrinks it will no longer have blood flows.

[KidneyBham in reply to Lionkin]

Thank you

[KidneyBham in reply to Lionkin]

Hi Lionkin, how many blood draws did you have to get to get you back to normal

[Lionkin in reply to KidneyBham]

Here are the details, Had KTR in July 19, Gfr in upper 70s, first diagnosed with excess RBC/Hematocrit/Hemoglobin toward end of June 2020, had Phlebotomy in July 2020, and then modified my diet to reduce Iron intake (no more iron fortified cereals, only Salmon no meat. September 15th Check for RBC etc looks normal. Then Ultrasound done to establish kidneys in Atrophy state. & no tumors or growth. I have to continue watching my diet or else end up having to go for a phlebotomy. As long as the RBC/Hematocrit go over the range say 52 and above phlebotomy has to be seriously considered to prevent blood clots & possibly a cardiac event.

[KidneyBham in reply to Lionkin]

So the only meat you eat is salmon right now?

[Lionkin in reply to KidneyBham]

Yes Salmon 3 times a week, all meat has Heme Iron which gets easily absorbed in the blood stream as against non heme iron (which is vegetables) Salmon is a combo of Heme & Non Heme iron and all the minerals too (Potassium/Phosphprous). Also I am not a big eater ...my family forces me to eat more in qty

Btw: Another thing I do is eat unsalted nut for minerals/fiber/good quality gluten free protein.

[KidneyBham in reply to Lionkin]

Thanks,y appt is Wednesday at 9, I’ll see what advice my doctors give and put it out here, my hematocrit is 51.1

[KidneyBham in reply to KidneyBham]

Had the phlebotomy today, all is well, my hematocrit was 51, they expect it to drop down to 47, thanks for helping me know what to look forward to. It wasn’t bad, it should have taken about 15-20 mins but I have small veins and my vein blew the first stick and the second stick it dripped very slow so the whole process took about 45 mins.

[Lionkin in reply to KidneyBham]

Hello KidneyBham, Glad to hear phlebotomy is done. In my case I have developed a side effect from the Phlebotomy, since the Hemoglobin levels dropped significantly , so did the Tacrolevels, apparently Dr mentioned if Hemoglobin decreases - there is less blood for Tacro to be absorbed, In my case the Tacro levels dipped below 5 and Tacro meds got increased, but fortunate that GFR is still around 79, .... thought I could share this. Next test is end of month , I am curious to see the test results.

[KidneyBham in reply to Lionkin]

Hi Lionkin, sorry to hear that, my next blood work is scheduled for the last Monday in the month, I’m praying I’ll be back to norm. They did add a baby aspirin 81mg to my list of meds