Red Blood Cells: Exchange, Transfuse, or Deplete.
ABO phenotype
Babesiosis
Erythrocytapheresis
Hematopoietic stem cell transplantation
Malaria
Red blood cell depletion
Red blood cell exchange
Sickle cell anemia
Transfusion
Journal
Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie
ISSN: 1660-3796
Titre abrégé: Transfus Med Hemother
Pays: Switzerland
ID NLM: 101176417
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
08
07
2019
accepted:
15
10
2019
entrez:
15
1
2020
pubmed:
15
1
2020
medline:
15
1
2020
Statut:
ppublish
Résumé
Erythrocytapheresis, red blood cell (RBC) depletion, and RBC exchange transfusions are apheresis techniques used to rapidly lower the circulating RBC mass or to exchange the patient erythrocyte mass with donor RBC. Automated RBC exchange is performed using an apheresis device, while manual RBC exchange is based on sequential phlebotomies and isovolemic replacement. Compared to simple RBC transfusions, RBC exchange offers several advantages, e.g., a lower risk for iron accumulation and efficient control of pathological erythrocyte populations. Disadvantages are the higher costs of the procedure, the increased use of donor RBC, and the requirement of apheresis devices and trained hospital staff. The most frequent indication for RBC exchange is sickle cell disease (SCD). RBC exchange transfusions are standard treatment in SCD patients with a history of or a risk for acute stroke and are clinical options for other acute complications of SCD. The most common indication for RBC depletion is the removal of donor RBC from the bone marrow grafts in major ABO-incompatible allogeneic hematopoietic stem cell transplantation to avoid immediate hemolysis. Rare indications for RBC exchange are severe infections with intraerythrocytic pathogens such as malaria or babesiosis and severe erythrocytosis or hereditary hemochromatosis where the aim is to rapidly decrease RBC populations or the iron content. However, only few high-quality studies are available looking at the efficacy of RBC exchange in the different disease entities, and treatment is often based on low levels of evidence and should therefore be decided in close collaboration with a transfusion medicine specialist.
Identifiants
pubmed: 31933570
doi: 10.1159/000504144
pii: tmh-0046-0407
pmc: PMC6944943
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
407-416Informations de copyright
Copyright © 2019 by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
The authors declare no financial conflicts.
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