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Transfusion therapy in sickle cell disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Transfusion in SCD is used either as an emergency measure or as prevention of short and long term complications of SCD (1).

There are 2 main objectives of blood transfusion in SCD:

  • to correct anaemia, which will improve the oxygen carrying capacity of blood
  • to lower the percentage of HbS relative to HbA in order to treat or prevent the occurrence of painful/vaso-occlusive or sequestration complications (1)

Transfusion in acute medical emergencies can be:

  • top up transfusion - in transient red cell aplasia, acute splenic sequestration
  • exchange transfusion - in acute stroke, acute chest syndrome, severe sepsis, acute hepatic sequestration, acute multiorgan failure

Indications for elective blood transfusion include:

  • for prevention of primary and secondary stroke
  • elective surgery
  • painful crises in pregnancy (1)

There are several important complications of blood transfusion which may have a negative impact on the long term health of the SCD patients.

  • alloimmunisation
  • infection - vaccination against hepatitis A and B should be offered to all those on long term transfusion programmes
  • iron overload - iron chelation should be started in all patients receiving regular blood transfusion according to standard protocols (1,2)

Reference:


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