ACT Procedure Day: What Happens From Arrival to Departure | ALIV

Medically Reviewed by Dr. Sunita Tandulwadkar | Written by ALIV

Knowing exactly what to expect on ACT procedure day reduces anxiety significantly and helps patients — and their families — plan and prepare appropriately. The procedure day at ALIV is longer than most outpatient clinical visits: from arrival through harvest, processing, administration, and post-procedure monitoring, patients should anticipate a full day at the clinic. Here is a complete timeline and explanation of each stage.

Arrival and Pre-Procedure Assessment (9:00–10:00 AM)

On arrival at ALIV's Pune or Mumbai clinic, the clinical team conducts a brief pre-procedure assessment: vital signs, a review of any changes in health status since the pre-ACT consultation, confirmation of fasting status (required for those undergoing bone marrow harvest under local anaesthesia with sedation option), and consent review. The patient is settled into the procedure suite and IV access is established if required for the protocol.

Harvest Procedure (10:00–11:30 AM)

The harvest procedure collects the autologous biological material that will be processed into the ACT preparation. The specific harvest depends on the protocol: For bone marrow harvest: The posterior superior iliac spine (hip bone) area is prepared and local anaesthetic infiltrated — first into the skin, then into the deeper layers including the periosteum (bone surface). A small puncture is made and a bone marrow aspiration needle introduced. The aspiration of 30–60ml of bone marrow typically takes five to ten minutes once adequate local anaesthesia is established. For adipose harvest: The abdomen or flank is sterilised and locally anaesthetised. A small-gauge lipoaspiration technique is used to harvest 30–100ml of adipose tissue through a minimal puncture site. Both procedures are typically well-tolerated under local anaesthesia, with patients reporting pressure sensation rather than sharp pain during aspiration.

Processing Period (11:30 AM–2:30 PM)

The harvested material is transferred immediately to ALIV's on-site processing laboratory. Patients rest comfortably during this period — this is a good time for a light meal (brought from home or available at the clinic), reading, or rest. The processing protocol involves centrifugation, cell separation, quality assessment of the preparation, and preparation of the final formulation for administration. The processing team communicates the estimated completion time to the clinical team. Patients should plan for this rest period to be two to four hours.

Administration (2:30–4:00 PM)

The processed ACT preparation is administered by the most appropriate route for the clinical indication. Intra-articular (for joint conditions): The joint is sterilised and the preparation injected under ultrasound guidance for accuracy. Intravenous (for systemic conditions): The preparation is infused slowly via the established IV access over 30–60 minutes. Intrathecal or other targeted routes (for neurological conditions): These are performed by the specialist team in the procedure suite. Post-administration, the patient is monitored for 30–60 minutes before discharge assessment.

Is the harvest procedure painful?

The harvest procedure is performed under local anaesthesia. Adequate time is given for the local anaesthetic to take full effect before the harvest begins — though the deep pressure of aspiration itself is often still felt. This is typically brief and the discomfort resolves within minutes of the aspiration being complete. For patients with significant anxiety about the procedure, mild sedation can be arranged; discuss this preference at the pre-ACT consultation. Adipose harvest is generally less uncomfortable than bone marrow aspiration for most patients.

Can my family member stay with me during the day?

Yes — and this is encouraged. Having a family member or support person present for the procedure day provides emotional support for the patient and allows someone who knows the patient well to hear the post-procedure instructions directly. Family members are typically asked to wait in the consultation area during the harvest procedure itself (for sterility reasons) but can be with the patient during the rest and monitoring periods.

What do I feel during IV administration of the processed preparation?

Most patients report minimal sensation during IV administration of the ACT preparation — the infusion rate is slow and the preparation is physiologically compatible. Some patients describe a mild warmth sensation at the infusion site. A small proportion of patients experience mild flushing or a sense of warmth more broadly — this is typically transient and resolves during or shortly after the infusion. Any unusual sensation should be reported to the nurse immediately for assessment.

When can I go home after the procedure?

Discharge typically occurs in the late afternoon following the 30–60 minute post-administration monitoring period. Patients must be accompanied home and should not drive. Most patients can resume light home activities the following morning, with full activity resumption guided by the post-procedure instructions for their specific protocol. See: ACT post-procedure recovery guide.

Medically Reviewed by Dr. Sunita Tandulwadkar. This article is for informational purposes only and does not constitute medical advice. Therapies offered by ALIV are proprietary, experimental protocols and results vary by individual.