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Updated: May 28, 2026
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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Blood transfusion in sickle cell disease
1Department of Pathology, Kuwait University, Safat, Kuwait. r-marouf@hsc.edu.kw
Hemoglobin
|October 11, 2011
Summary
Sickle cell anemia, caused by abnormal hemoglobin S, leads to red blood cell sickling and vaso-occlusion. Blood transfusions are reserved for specific severe crises, not routine painful episodes.
Area of Science:
- Hematology
- Genetics
- Vascular Biology
Background:
- Sickle cell anemia is an inherited disorder causing chronic hemolytic anemia due to abnormal hemoglobin S (Hb S).
- Hb S polymerization under low oxygen tension leads to red blood cell rigidity, vaso-occlusion, and painful crises.
- Patients exhibit variable hemoglobin levels, with crises being a common reason for hospitalization.
Purpose of the Study:
- To review the indications and considerations for blood transfusion in patients with sickle cell disease.
- To highlight the risks associated with blood transfusions and the importance of careful patient selection.
- To outline specific transfusion strategies for various sickle cell disease complications.
Main Methods:
- Review of existing literature on sickle cell disease pathophysiology and transfusion practices.
- Analysis of clinical guidelines and recommendations for blood product use in sickle cell patients.
- Discussion of Hb S properties, oxygen affinity, and transfusion goals.
Main Results:
- Blood transfusions in sickle cell disease aim to improve oxygen tissue delivery, particularly for Hb S, which has lower oxygen affinity than Hb A.
- Transfusions are indicated for acute hemolytic, aplastic, or sequestration crises, and prophylactically for stroke prevention.
- Exchange transfusions are employed for acute chest syndrome, priapism, and perioperative management.
Conclusions:
- Blood transfusions in sickle cell disease are a critical but high-risk intervention with specific indications.
- Transfusion protocols must consider Hb S negativity, and Rh and Kell antigen matching.
- Careful patient selection and monitoring are essential to mitigate transfusion-related complications.
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