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    Patent Pending

    Sickle Cell RBC Exchange Volume

    Estimates the volume of donor RBCs needed for RBC exchange in patients with sickle cell disease.

    INSTRUCTIONS

    Note: device manufacturers may provide separate calculations for automated exchange.

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with sickle cell disease complications requiring RBC exchange.

    • Due to frequent exposures to donor RBCs, patients with sickle cell disease are at high risk for developing RBC alloimmunization and many centers require some level of antigen matching.
    • In patients necessitating RBC exchange for an acute complication, if the pre-exchange percent hemoglobin S (HbS%) is unavailable, assuming that it is equal to 100% can be a conservative measure.  
    • Transfused blood for sickle cell patients should be antigen negative for any patient RBC alloantibodies, crossmatch compatible, and sickle negative.
    • This calculation is intended to produce the same hematocrit post-procedure as pre-procedure. Apheresis instruments have on-board calculators to adjust hematocrit according to user-entered preferences, which may necessitate adjustments to RBC replacement volume.
    • Sickle cell disease is associated with a number of complications, including pain crises, acute chest syndrome, and stroke. Automated RBC exchange is an effective therapeutic modality both in the acute treatment of severe sickle cell-related complications and in long-term maintenance.  
    • Calculating the volume of donor RBCs necessary to achieve appropriate reduction in HbS% is useful when ordering blood for RBC exchange procedures.  
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    Next Steps
    Evidence
    Content Contributors
    • Alex Ryder, MD, PhD
    • Caleb Cheng, MD
    • Christopher Tormey, MD
    Content Contributors
    • Alex Ryder, MD, PhD
    • Caleb Cheng, MD
    • Christopher Tormey, MD