Current issues in blood transfusion for sickle cell disease

Area of Science:

• Hematology
• Transfusion Medicine
• Genetics

Background:

• Blood transfusions have been used for sickle cell disease (SCD) since the 1950s.
• Early complications limited transfusion use in SCD patients.
• Recent advances have improved transfusion safety and efficacy.

Purpose of the Study:

• To review the indications, methods, goals, and complications of blood transfusion in SCD.
• To discuss recent changes in transfusion therapy for SCD.
• To highlight the evolving role of transfusion in managing SCD complications.

Main Methods:

• Review of landmark studies and recent research on transfusion therapy in SCD.
• Analysis of established and emerging indications for transfusion.
• Discussion of strategies to mitigate transfusion complications.

Main Results:

• Transfusions are effective in preventing stroke, treating acute chest syndrome, and perioperative management in SCD.
• Pulmonary hypertension is an emerging indication for transfusion therapy in SCD.
• Phenotypic matching reduces alloimmunization; genotyping may improve future donor matching.

Conclusions:

• Red blood cell transfusion is a well-studied and accepted therapy for acute and chronic SCD complications.
• Transfusion use in SCD may be balanced by newer therapies like hydroxyurea.
• Physicians must understand the unique transfusion needs and complications in SCD patients.