Red Cell Transfusion in Sickle Cell Disease Part I

This guideline addresses the specific indications for transfusion in SCD. Transfusions can be given for either acute or chronic complications of SCD.

Blood transfusion in sickle cell disease (SCD) can be potentially lifesaving but can also be associated with morbidity.  Transfusions can be given either as a top up or exchange transfusion taking into account factors such as the indication for transfusion, the need to avoid hyper viscosity, minimise allo-immunisation, iron balance and venous access issues.

All patients must have extended red cell antigen typing performed. The red cell units selected for transfusion should be ABO compatible, Rh and Kell matched, HbS negative, and antigen negative for any clinically significant red cell antibodies. Where possible blood for top up transfusion should be <10 days old and <7 days old for exchange transfusion. The decision to transfuse or not should have the input of a clinician with expertise in managing patients with SCD. All hospitals likely to admit patients with SCD should have access to manual exchange procedures; in larger centres should have access to automated red cell exchange. Complications of transfusion in SCD include allo-immunisation, iron overload and haemolytic transfusion reactions.