Quantitative phlebotomy performed during treatment may provide an alternative to liver biopsy, CT, or MRI for documenting iron overload. The removal of 4 to 5 grams of iron through documented successive phlebotomies (16 to 20 phlebotomies) without the development of anemia is indicative of iron overload. One unit, or 450 mL, of blood, is assumed to contain approximately 200 to 250 mg of iron.
Quantitative phlebotomy is helpful in patients whose liver biopsy is contraindicated or who refuse the procedure. It is also typically less costly.
