Description
Title: Safety and Effectiveness of Manual Partial Red Cell Exchange in the Treatment of Severe Sickle Cell Disease Complications in a Developing Country
Abstract: Introduction. The lack of blood, equipment, and transfusion safety are obstacles to the implementation of red cell exchange (RCE) in Africa. We assessed its effectiveness and safety in patients with severe sickle cell disease complications. Method and Patients. Patients with severe complications from sickle cell disease underwent manual partial RCE. Clinical evolution, blood counts, and hemoglobin electrophoresis were used to gauge effectiveness. Adverse reactions, infections, and alloimmunization were used to evaluate safety. Results. 44 patients, including 41 homozygous (SS) and 2 heterozygous composites (SC and 1 S/0-thalassemia), underwent 166 partial RCEs. It had a mean of 27.9 years. There was a 1.58 sex ratio. 100% of cases of persistent vasoocclusive crisis, acute chest syndrome, 56.7% of intermittent priapism, and 30% of stroke experienced complete symptom regression. It was absent in cases of acute priapism and partial in 100% of leg ulcers. After a single procedure, the mean variations in hemoglobin and hematocrit rate were +1.4 g/dL and +4.4%, respectively. Following two consecutive RCE, it was 60% for hemoglobin S. Both viral seroconversion and alloimmunization were not seen. Conclusion. This study demonstrates the viability of manual partial RCE in a setting with limited resources, as well as its effectiveness and safety during complications of SCD other than acute priapism.
Paper Quality: SCOPUS / Web of Science Level Research Paper
Subject: Medicine
Sub Category: Hematology
Writer Experience: 20+ Years
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