Asian Journal of Transfusion Science
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Year : 2020  |  Volume : 14  |  Issue : 1  |  Page : 70-73

Red blood cell exchange in sickle cell disease patient with multiple alloantibodies

1 Department of Transfusion Medicine, Medanta – The Medicity, Gurgaon, Haryana, India
2 Department of Medical Oncology and Hematology, Medanta – The Medicity, Gurgaon, Haryana, India

Correspondence Address:
Dr. Aseem Kumar Tiwari
Department of Transfusion Medicine, Medanta – The Medicity, Sector-38, Gurgaon - 122 001, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajts.AJTS_36_18

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There are several reports in medical literature about Red Cell Exchange (RCE) being routinely performed pre-operatively in sickle cell disease patients to provide immediate decrease in HbS concentration and prevent post-operative complications. We would like to present one such case of SCD who also had multiple allo-antibodies and had to undergo hemi-arthroplasty for avascular necrosis of head femur. Grouping and antibody screening was performed using column agglutination technique. 3-cell and 11- cell panel were used for antibody screening and identification, respectively. Automated RBC exchange was performed on apheresis machine Com.Tec using the standard PL1 kit (Fresenius Kabi, Germany). Multiple (anti-c, E) allo-antibodies were identified and successful pre-operative RCE was done with corresponding antigen-negative AHG compatible RBC units. Single RCE procedure reduced HbS concentration from 65% to 25%. The patient underwent uneventful hemi-arthroplasty and was discharged on post-operative day-7. Patient is on regular follow-up and continues to do well two months after the day of surgery. This is possibly the first case report from India, which illustrates successful automated RCE in a SCD patient with alloimmunization.

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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006