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Adverse events of red blood cell transfusions in patients with sickle cell disease

  • Margo R. Rollins
    Affiliations
    Children’s Healthcare of Atlanta, Department of Pathology and Laboratory Medicine, 1405 Clifton Rd NE, 1st Floor, Atlanta, GA 30322, USA

    Emory University School of Medicine, Department of Pediatrics, Aflac Cancer and Blood Disorders Center, 1405 Clifton Rd NE, Atlanta, GA 30322, USA
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  • Stella T. Chou
    Correspondence
    Correspondence to: 3615 Civic Center Boulevard, Abramson Research Building Room 316D, Philadelphia, PA 19104, USA.
    Affiliations
    The Children’s Hospital of Philadelphia, Departments of Pediatrics and Pathology and Laboratory Medicine, The School of Medicine at the University of Pennsylvania, 3615 Civic Center Boulevard, Abramson Research Building Room 316D, Philadelphia, PA 19104, USA
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      Highlights

      • Alloimmunization and iron overload are risks of red cell transfusion for SCD.
      • Prophylactic Rh and K matching of red cells is recommended for patients with SCD.
      • RH variation among African patients and donors contributes to Rh alloimmunization.
      • Immunosuppression can be tailored for severe hemolytic transfusion reactions.

      Abstract

      Blood transfusion is a common medical intervention for patients with sickle cell disease (SCD) and disease related complications. While patients with SCD are at risk for all transfusion related adverse events defined by the National Healthcare Safety Network (NHSN) Biovigilance Component Hemovigilance Module Surveillance Protocol, they are uniquely susceptible to certain adverse events. This review discusses risk factors, mitigation strategies, and management recommendations for alloimmunization, hemolytic transfusion reactions, hyperviscosity and transfusion-associated iron overload in the context of SCD.

      Keywords

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