Erythrocytapheresis for chronic transfusion therapy in sickle cell disease: survey of current practices and review of the literature

Kelly, Shannon; Quirolo, Keith; Marsh, Anna-Marie; Neumayr, Lynne; García, Alberto Torres; Custer, Brian

doi:10.1111/trf.13800

Cited by 28 publications

(31 citation statements)

References 49 publications

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“…There are three modes of transfusion therapy: simple transfusion, manual exchange transfusion (MET), and erythrocytapheresis, also called automated red blood cell exchange (aRBCX). The type of transfusion therapy used depends on institutional preference and perceived risks and benefits of the different modalities . Simple transfusion does not require central venous access, but causes greater iron overload.…”

Section: Introductionmentioning

confidence: 99%

Increased complications of chronic erythrocytapheresis compared with manual exchange transfusions in children and adolescents with sickle cell disease

Woods

Hayashi

Binkley

et al. 2017

Pediatric Blood & Cancer

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Section: Introductionmentioning

confidence: 99%

Increased complications of chronic erythrocytapheresis compared with manual exchange transfusions in children and adolescents with sickle cell disease

Woods

Hayashi

Binkley

et al. 2017

Pediatric Blood & Cancer

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“…In a recent survey, it was found that simple transfusion tends to be preferred over automated RBC exchange transfusion in children (52% vs. 37%) but is preferred less in adults (30% vs. 52%), with manual exchange being the least preferred method in both groups . The most commonly cited barriers to RBC exchange were vascular access and limited access to equipment and personnel …”

Section: Rbc Exchange Treatment Considerationsmentioning

confidence: 99%

“…Some form of vascular access is required, and several factors must be considered for the optimal treatment of the patient . This decision itself depends on the selection of the most appropriate modality for removal and/or replacement of RBCs, including automated RBC exchange, partial manual exchange, and simple transfusion . Complications are common and can be attributed to both the exchange modality and the vascular access used .…”

mentioning

confidence: 99%

Vascular access for red blood cell exchange

2018

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Red blood cell exchange is the process of removing red blood cells from a patient and replacing them with donated blood using either automated or manual techniques. Red blood cell exchange is a well‐recognized and effective therapy for many red blood cell‐related diseases, especially sickle cell disease. However, decisions regarding the best methods for vascular access are not intuitive and must account for the patient's clinical condition, complication risks, and lifestyle, especially in the context of long‐term vascular access. In this review, we discuss the recognized indications for red blood cell exchange, considerations for the selection of exchange modality and vascular access, and recommendations for the appropriate care and prevention of risks associated with vascular access.

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“…Red cell exchange (RCE) often serves as a method to deliver chronic transfusion therapy . RCE is commonly used for patients with sickle cell disease (SCD) who are in need of lifelong transfusion therapy to treat complications of SCD such as stroke . The major benefit of RCE compared to simple transfusion is preventing or reducing transfusional iron overload …”

Section: Introductionmentioning

confidence: 99%

The sex parameter in estimation of total blood volume for pediatric erythrocytapheresis

Colavita

Kim

Friedman

2019

J of Clinical Apheresis

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Background and Objectives Estimation of the total blood volume (TBV) is fundamental to the control of automated red cell exchange (RCE). Error in the TBV estimate can produce outcomes that deviate from the prescribed targets, and may endanger the patient. Both the Spectra Optia and the COBE Spectra use the Nadler formulae to estimate TBV. There is a potential for large overestimates of TBV when the Nadler formula for males is applied to prepubertal boys. Materials and Methods This study uses our large clinical experience with RCE to examine procedure outcomes when RCE in prepubertal boys is programed with the female parameter instead of male. We determined the differences between programmed and measured values for three outcomes: (a) Programmed End Hematocrit − Post spun HCT by Hemata Stat II, (b) Programmed End Hematocrit − Post CBC HCT, and (c) Predicted Post Hgb S+C − Measured Post Hgb S+C. We defined the experimental group as Male‐Female, where the biological sex was male but programmed sex was female, and two control groups where programmed and biological sex were the same. Results Small but statistically significant differences were demonstrated between the mean programmed‐to‐observed deviations of these outcome measures in all but two group and subgroup comparisons; however, the absolute magnitudes of the observed differences were not clinically significant. The suggested weight cutoff to begin programming males as male is 35 kg. Conclusion The study provides experiential validation that performing RCE in prepubertal boys using the female parameter is safe.

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Erythrocytapheresis for chronic transfusion therapy in sickle cell disease: survey of current practices and review of the literature

Abstract: The current literature review was conducted to summarize reported methods, outcomes, and adverse effects with aRBX. Comparisons between chronic simple and aRBX transfusions were included when possible, and areas warranting further study are highlighted.

Cited by 28 publications

References 49 publications

Increased complications of chronic erythrocytapheresis compared with manual exchange transfusions in children and adolescents with sickle cell disease

Increased complications of chronic erythrocytapheresis compared with manual exchange transfusions in children and adolescents with sickle cell disease

Vascular access for red blood cell exchange

The sex parameter in estimation of total blood volume for pediatric erythrocytapheresis

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