AUTOMATED RED-CELL EXCHANGE IN SICKLE-CELL DISEASE

Red cell exchange is important in the care of acutely ill sickle-cell patients, and may be life-saving. An automated red cell exchange techn ique has been developed using a Baxter blood cell separator, enabling an isovolaemic exchange to be performed within 2.5 h. A total of 20 pr ocedures have been performed in 15 patients, including one woman in th e third trimester of pregnancy, with a mean decrease of 72% in the cir culating sickle haemoglobin (HbS) level. This method enables almost al l adult patients with sickle cell anaemia to have their HbS reduced to safe levels by only one procedure. The procedure was well tolerated b y all patients, including those who were acutely ill. This technique p rovides an effective procedure for reducing the percentage of circulat ing HbS rapidly in acutely ill patients with complications of sickle c ell anaemia.