Vascular access for red blood cell exchange

• Published in: Transfusion (Philadelphia, Pa.) Vol. 58; no. S1; pp. 569 - 579
• Main Authors: Otrock, Zaher K., Thibodeaux, Suzanne R., Jackups, Ronald
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-02-2018
• Subjects: Blood; Blood Component Removal - instrumentation; Blood Component Removal - methods; Catheterization, Central Venous - instrumentation; Catheterization, Central Venous - methods; Catheterization, Peripheral - instrumentation; Catheterization, Peripheral - methods; Erythrocyte Transfusion - instrumentation; Erythrocyte Transfusion - methods; Erythrocytes; Exchanging; Humans; Sickle cell disease; Vascular Access Devices; Venous access
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/trf.14495

Red blood cell exchange is the process of removing red blood cells from a patient and replacing them with donated blood using either automated or manual techniques. Red blood cell exchange is a well‐recognized and effective therapy for many red blood cell‐related diseases, especially sickle cell disease. However, decisions regarding the best methods for vascular access are not intuitive and must account for the patient's clinical condition, complication risks, and lifestyle, especially in the context of long‐term vascular access. In this review, we discuss the recognized indications for red blood cell exchange, considerations for the selection of exchange modality and vascular access, and recommendations for the appropriate care and prevention of risks associated with vascular access.