Transfusion practices for patients with sickle cell disease at a major academic medical center

The University of North Carolina at Chapel Hill (UNC) is a tertiarycare, academic university hospital and a major referral center for patients across the state of North Carolina. This 700-bed, Level 1 trauma center transfuses more than 22,000 RBC units to patients annually. Clinical services and areas of the hospital which rely most heavily on transfusion support for their activities are transplantation (bone marrow and solid organ), hematology, critical care (medical and surgical intensive care units), cardiothoracic surgery, pediatrics, the operating room, the emergency department, labor and delivery, dialysis, and outpatient services. UNC is recognized for its expertise in coagulation, transfusion medicine, and hematology, particularly in sickle cell disease (SCD). The sickle cell center at UNC, which began in 1980 and continues today, in conjunction with our neighboring institution,Duke University Medical Center, is designated as part of a National Institutes of Health comprehensive sickle cell center. Several of the physicians are dedicated to the care of pediatric and adult patients with SCD, as well as to research on transfusion management of these patients and recruitment of African American blood donors. This article describes the practices of this institution for transfusion management of patients with SCD, as well as some of its efforts related to this challenging area of transfusion medicine.