Transfusion therapy in sickle cell disease patients: methods and acute indications.
Management of transfusion therapy in sickle cell disease patients with acute complications is often made difficult because of confusing indications, a variety of methods, disparate goals, and varying needs for maintenance transfusion. In priapism, acute chest syndrome, many major surgical procedures, toxemia of pregnancy, and cerebrovascular accidents, the target hemoglobin A level should be made as close to 100% as possible by mechanized red blood cell exchange. If mechanized exchange is unavailable, manual exchange should be instituted. Hemoglobin A should be maintained at greater than 60% to 70% by periodic simple transfusion until patients are fully recovered. Stroke patients should undergo maintenance transfusions for at least 3 years and perhaps 5 to 12 years. Physicians and patients should be aware of the transfusion-related risks of hepatitis and HIV infection. Alloimmunization and iron overload should be minimized in patients requiring frequent transfusions and chelation therapy should be utilized for iron overload.
Campbell
L C
LC
Dept of Medicine, Louisiana State University School of Medicine-Shreveport.
Von Burton
G
G
Holcombe
R F
RF
D000755:Anemia, Sickle Cell / Q000150:complications / Q000628:therapy*; D001803:Blood Transfusion / Q000379:methods; D006801:Humans; D065227:Transfusion Reaction