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Blood Transfusion

 Simple (Top-Up) Blood Transfusion

 Blood transfusion is indicated if:

  • There are acute symptoms of anaemia, such dyspnoea, tachycardia, severe weakness 

  • Haemoglobin level is < 6g/dl 

  • Haemoglobin level has dropped by > 2g/dl below the steady-state value.

Note : Because the cardiovascular system adjusts to the chronic anaemia, blood transfusion is not routinely indicated in steady state SCD simply for the reason that haemoglobin level is below 8–10g/dl.

Exchange Blood Transfusion 

Venesection to reduce the proportion of HbS red cells with transfusion of normal HbA blood is often beneficial in the treatment or prevention of life-threatening and other manifestations of sickle cell disease 5. Hence, the aim in this process of exchange blood transfusion (EBT) is to reduce HbS to 30%. Exchange blood transfusion can be done manually or automatically with a red cell apheresis machine.


Indications for Exchange Blood Transfusion

  • Cerebrovascular Accidents (CVAs) 

  • Acute Chest Syndrome (ACS) 

  • Prior to major surgery 

  • Multi-organ failure, including Systemic Marrow Fat Embolism (SMFE) 

  • Multiple pregnancies 

  • Prevention of recurrent stroke.  

Relative Indications for Exchange Blood Transfusion

  • Intractable or very frequent severe crises 

Major priapism unresponsive to other therapy

Updated on, 27.10.2020


1. STG page number 10-12

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