تبديل الكريات الحمر الآلي في فقر الدم المنجلي

الملخص EN

Background& Objective: The majority of patients with SCD receive transfusions at some point in their life.

Transfusion can be simple transfusion or exchange transfusions which offer better control of blood volume and viscosity.

Such transfusions are most readily accomplished via automated red cell exchange.

Evaluate the results of our experience in applying the technique of selective cell separation by continuous flow (Cytapheresis) for automated red cell exchange for patients with sickle cell anemia to reduce the level of hemoglobin S (HbS) in certain cases, especially in preparation for major surgery.

Materials & Methods: analytic retrospective study of the results of the automated red cell exchange using selective cell separation technology between 2005 -2007.

The procedure was performed using a Fresenius Com.Tec cell separator from Fresenius AG, Bad Homburg, Germany.

For the red cell exchange we use a leuco-depleted and phenotyped (Rh, K) packed red cell or packed red cell with more extended phenotyping when necessary after cross-match test with the patient serum.

For every patient this laboratory monitoring was done: ABO Rh D blood group, Ht, Hb, HbS level before and after the automated red cell exchange Results: In 2005-2007 15 sessions of automated red cell exchange conducted for 15 patients with sickle cell anemia, the average age and male / female ratio was: 31.2 years and 7 / 8, respectively.

The major Indications were as following: orthopedic surgery 53.3%, cholecystectomy 26.6%, resistant painful crises 6.6%, resistant painful priapism 6.6%, and resistant ulcer leg 6.6%.

Average percentage of hemoglobin S (HbS) reduction was 52%, the average volume of packed red cell used was 1412.4 ml, and the average session time was 76.5 minutes.

Conclusion: Automated red cell exchange was a new application of selective cells separation technology in the treatment of patients with sickle cell anemia in our country and the results were satisfactory, this technique is safe and simple, and most importantly, it appears to be very effective because in all patients, one session led HbS level to 20-38%, which is a sufficient level to resolve episodes of vascular obstruction and safe for most major surgeries.