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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

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Published on: March 14, 2017

Transfusion in Hospice-Palliative Care.

¹Department of Palliative Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

Journal of Hospice and Palliative Care

|June 11, 2026

Summary

This summary is machine-generated.

Red blood cell transfusion in hospice care is complex. While it can relieve symptoms like fatigue and dyspnea, its benefits are often temporary, and access varies. Case-by-case decisions are crucial.

Keywords:

Anemia Blood transfusion Hospice care Palliative care

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Last Updated: Jun 12, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

Area of Science:

Palliative Care
Hematology
Medical Ethics

Background:

Anemia is prevalent in terminally ill patients, causing significant symptom burden including fatigue and dyspnea.
Red blood cell transfusion offers potential short-term symptom relief but has limited impact on survival and can be transient.
Clinical practices regarding transfusion in hospice and palliative care are inconsistent due to differing views on its role.

Purpose of the Study:

To explore the complexities of red blood cell transfusion in hospice and palliative care.
To highlight the impact of transfusion on symptom management and patient/family decision-making in terminal illness.
To advocate for an individualized, goal-concordant approach to transfusion decisions.

Main Methods:

Case study of an 88-year-old male with myelodysplastic syndrome requiring transfusion-dependent care.
Analysis of the patient's experience with fatigue, symptom control, and hospice admission decisions.
Discussion of institutional barriers and logistical constraints affecting transfusion access in hospice settings.

Main Results:

Transfusion significantly impacted the patient's fatigue and influenced decisions regarding hospice care, delaying admission.
The case illustrates that transfusion can be clinically significant for symptom relief and shaping patient preferences, not just survival.
Access to transfusion services varied, posing challenges for hospice and home care settings.

Conclusions:

Transfusion in hospice and palliative care necessitates a case-by-case evaluation.
Decisions should be based on symptom burden, prognosis, patient values, treatment burden, feasibility, and ethical principles.
Shared decision-making and ongoing reassessment are essential for goal-concordant care.