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Updated: Aug 10, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
The transfusion service is an integral and important component of the hospital and should not be outsourced
1Department of Clinical Pathology, Cleveland Clinic Foundation, OH 44195, USA.
Hospitals are under increased pressure to decrease operating costs. Hospital-based laboratories, blood banks (transfusion services), increasingly face the potential of being outsourced as hospitals try to survive the current waves of managed care. A number of complicated and unique services are provided by the hospital-based transfusion service and physician. Clinical consultation, complicated immunohematological procedures, apheresis, participation in a complex array of patient-care services, clinical research, ever increasing regulatory issues, and quality assurance activities are only a few of the challenges in today's transfusion medicine environment. This paper will focus on the hospital-based transfusion service, and the transfusion medicine physician, and present arguments as to why this service should remain close to the patient's bedside and not be outsourced.
Hospitals are under increased pressure to decrease operating costs. Hospital-based laboratories, blood banks (transfusion services), increasingly face the potential of being outsourced as hospitals try to survive the current waves of managed care. A number of complicated and unique services are provided by the hospital-based transfusion service and physician. Clinical consultation, complicated immunohematological procedures, apheresis, participation in a complex array of patient-care services, clinical research, ever increasing regulatory issues, and quality assurance activities are only a few of the challenges in today's transfusion medicine environment. This paper will focus on the hospital-based transfusion service, and the transfusion medicine physician, and present arguments as to why this service should remain close to the patient's bedside and not be outsourced.
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