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3.3: Blood Transfusion

Table of Contents

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.

The codes will be shown below

First: 170598
Second: 180198

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