[Transfusion and sickle cell disease: axes of transfusion safety optimization]

Transfusion remains a major treatment in sickle cell disease. In France, sickle cell disease patients are mainly from Sub-Saharan Africa and West Indies. The immuno-hematological characteristics of these patients of African ancestry induce a short supply of compatible packed red blood cells and an increased rate of haemolytic transfusion reactions, compared to the general transfused population. The optimization of transfusion safety relies on all steps of the transfusion chain. This article aims to describe the current situation in France and to determine the axes of optimization at all steps of the transfusion organization: promotion of donation, preparation of products, taking into account the sickle trait, qualification of packed red blood cells, supply of the blood banks concerned by transfusion of these patients, transfusion protocols and pre transfusion analysis. Research and formation play an important part.