Clinical consequences of iron overload from chronic red blood cell transfusions, its diagnosis, and its management by chelation therapy.
Iron overload from chronic transfusion therapy can be extremely toxic. Excess transfusional iron is deposited in the liver, heart, and other organs as free iron, which can cause organ dysfunction and damage over time. Increased awareness of the risk of iron overload in patients requiring chronic transfusion therapy is needed, and such patients should be screened for hyperferritinemia. Those with serial serum ferritin levels exceeding 1000 ng/mL and a total infused red blood cell volume of 120 mL/kg of body weight or more should be treated with chelation therapy and then monitored to ensure that treatment adequately reduces iron levels.
Shander
Aryeh
A
Department of Anesthesiology, Critical Care Medicine, and Hyperbaric Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey 07631, USA. aryeh.shander@ehmc.com
Sazama
Kathleen
K
D001706:Biopsy; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D006801:Humans; D007501:Iron / Q000378:metabolism; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D019190:Iron Overload / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008099:Liver / Q000473:pathology
D007502:Iron Chelating Agents; D007501:Iron