Isovolumetric partial exchange transfusion in the management of sickle cell disease in pregnancy

A technique that permits isovolumetric partial exchange transfusion is presented, with experience from 10 partial exchange transfusions in five obstetric patients with sickle cell disease. The technique is performed in an outpatient setting and requires less than two hours once blood has been cross matched. A mathematical model of the blood volume is used to predict final hematocrit and final hemoglobulin (Hgb) A percentage and to compare this technique with a previously described algorithm. Once the decision to perform a partial exchange transfusion has been made, this technique affords diminished risk to the patient and economy of time and money by permitting prediction of the hematocrit and percentage normal hemoglobin (% Hgb A) resulting from various transfusion/withdrawal volumes.