Automated erythrocytopheresis for sickle cell anemia during pregnancy

Prophylactic red blood cell exchange may be beneficial in the management of sickle cell disease in pregnancy

“…Some studies have shown that the use of prophylactic RBCX in pregnancy can be effective and well tolerated by the mother to be as well as the fetuses . In particular, this procedure may lead to maternal benefits, such as a reduced number and duration of hospital admissions, a reduction in the number of simple top‐up transfusions, and less need for other supportive therapy .…”

“…28 Some studies have shown that the use of prophylactic RBCX in pregnancy can be effective and well tolerated by the mother to be as well as the fetuses. 31,34,35 In particular, this procedure may lead to maternal benefits, such as a reduced number and duration of hospital admissions, a reduction in the number of simple top-up transfusions, and less need for other supportive therapy. 31,35 Neonatal advantages are also described, since it has been proven that the number of preterm deliveries, the prevalence of low-birthweight fetuses, and the perinatal death rate are significantly lower in children of routinely transfused SCD patients.…”

“…31,34,35 In particular, this procedure may lead to maternal benefits, such as a reduced number and duration of hospital admissions, a reduction in the number of simple top-up transfusions, and less need for other supportive therapy. 31,35 Neonatal advantages are also described, since it has been proven that the number of preterm deliveries, the prevalence of low-birthweight fetuses, and the perinatal death rate are significantly lower in children of routinely transfused SCD patients. 31 Our study patients had end organ failures before pregnancy and they were admitted to hospital several times due to causes like painful vasoocclusive crises (n = 24), recurrent infections (n = 20), acute chest syndrome (n = 5), leg ulcers (n = 6), hepatic necrosis (n = 1), neurologic events (n = 2), and bone necrosis (n = 2) so they had undergone RBCX procedures.…”

Therapeutic Apheresis

“…Apheresis techniques may also be used for erythrocyte exchange, which has been recently studied for sickle cell anemia in cri sis and during pregnancy [85,88], Erythrocytapheresis has also been applied to severe autoimmune hemolytic anemia [160], and severe parasitemia, such as malaria and babesiosus [26], with lifesaving results.…”

Selective removal of sickle cells with the IBM 2997 continuous flow blood cell separator

“…While these methods are effective, they are time consuming, tedious, and increasingly inefficient as the percentage of transfused cells increases. Recent reports stress the safety, ease, and speed of automated red cell exchanges performed with either intermittent-flow [3,4] or continuous-flow blood cell separators [5,6]. Little information exists concerning the conditions for the most efficient removal of hemoglobin S (HbS) containing cells with these instruments.…”