Blood exchange, also known as therapeutic erythrocytapheresis or therapeutic phlebotomy, is a procedure used in the management of sickle cell disease (SCD). In this procedure, a patient’s blood is partially or completely removed and replaced with healthy donor blood or red blood cell concentrates. Here are some potential benefits of blood exchange in sickle cell patients:
1. Reducing the percentage of sickle hemoglobin (HbS): In SCD, the red blood cells become rigid and take on a sickle shape due to the presence of abnormal hemoglobin (HbS). Blood exchange helps reduce the overall percentage of HbS in the patient’s blood by replacing it with healthy red blood cells. This can alleviate the symptoms associated with sickling, such as pain crises, organ damage, and anemia.
2. Diluting concentrated sickle cells: Sickle cells tend to clump together, leading to the formation of blood clots and obstruction of blood vessels. By removing a portion of the patient’s blood and replacing it with healthy donor blood, blood exchange dilutes the concentration of sickle cells. This reduces the likelihood of clumping and improves blood flow, reducing the risk of complications like stroke or acute chest syndrome.
3. Increasing the number of healthy red blood cells: Sickle cell patients often experience chronic anemia due to the destruction of their sickle-shaped red blood cells. Blood exchange increases the number of healthy red blood cells in circulation, improving oxygen-carrying capacity and reducing anemia-related symptoms, such as fatigue and shortness of breath.
4. Lowering the risk of iron overload: Sickle cell patients frequently require blood transfusions to manage their condition. However, repeated transfusions can lead to iron overload in the body, which can cause organ damage. Blood exchange helps remove excess iron along with the patient’s own blood, reducing the risk of iron overload complications.
5. Providing a temporary reprieve from symptoms: Blood exchange is not a permanent cure for SCD, but it can provide temporary relief from symptoms and complications associated with the disease. By improving blood circulation and oxygenation, the procedure may reduce pain, prevent organ damage, and enhance overall well-being in sickle cell patients.
It’s important to note that blood exchange is typically used as a therapeutic option in specific situations, such as acute complications or when other treatment approaches have been ineffective. The suitability and frequency of blood exchange depend on the individual patient’s condition and the recommendations of their healthcare team.
Blood exchange maybe suggested in patients
1. Hemoglobin Hbss levels of greater than 80%
2. A patient with frequent vassocculusive crisis and hydroxyurea has not helped
3. Patients who have suffered stroke
4 pregnant sickle cell patients
5.patients with persistent priaprism
6.patients with multiple sickle cell complications
Ask your doctor if you as a patient are eligible for blood exchange . Now this procedure is present in Zambia at UTH
By Dr.Musonda Mwilwa (Facebook post)