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Updated: Jan 27, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Selecting red blood cell units to perform RBCX in patients with sickle cell disease
1Delivery and Immunohematology Unit, Etablissement Français du Sang, Centre Hospitalier Lyon Sud, Lyon, France.
Abstract:
Red blood cell exchange (RBCX) is a standard option for treating or preventing complications in patients with sickle cell disease (SCD). According to the patient's blood volume, the amounts of red blood cells (RBC) to be exchanged and the practices of the apheresis and clinical teams, such treatment requires numerous red blood cell units (RBCUs) (3-15 RBCUs per procedure). To perform RBCXs safely and prevent the risk of alloimmunization, appropriate RBCUs must be selected and transfused to replace the sickled RBCs. Understanding of alloimmunization in patients with SCD strengthened the development of recommendations for preventing the risk of alloimmunization. This review describes the alloimmunization risk, the methods used to decrease the risk, and our own experience.
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