Successful long-term erythrocytapheresis therapy in a patient with symptomatic sickle-cell disease using an arterio-venous fistula.
The use of long-term automated erythrocytapheresis via an arterio-venous fistula for the prevention of recurrent ischaemic stroke in a child with sickle-cell disease (SCD) has not been described previously. We report the successful use of this technique in a 13-year-old boy. A procedure was performed every 36 +/- 6 days, transfusing six units of donor packed red blood cells (RBCs) and discarding 1318 +/- 174 mL of exchanged erythrocytes (Hct 60%). After transfusion of 85 units over 17 months, there is no evidence for iron-overload, red cell alloimmunization, transfusion-transmitted infections, or other complications. Until now, no cerebrovascular ischaemia has been observed.
Hartwig
D
D
Institute for Immunology and Transfusion Medicine, Medical University of Lübeck, Germany. hartwig@immu.mu-luebeck.de
Schläger
F
F
Bucsky
P
P
Kirchner
H
H
Schlenke
P
P
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000628:therapy*; D001166:Arteriovenous Shunt, Surgical; D001781:Blood Component Removal; D017707:Erythrocyte Transfusion / Q000379:methods*; D006801:Humans; D008297:Male; D012008:Recurrence; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome