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Safety and benefits of automated red cell depletion-exchange compared to standard exchange in patients with sickle cell disease undergoing chronic transfusion. | LitMetric

AI Article Synopsis

  • The Spectra Optia machine automates red blood cell reduction and isovolemic hemodilution (IHD) before red cell exchange, primarily for sickle cell disease patients, though safety data is limited.
  • In a study involving six sickle cell disease patients, they compared safety and benefits between standard red cell exchange and IHD-RCE, finding some minor decreases in blood pressure but significant benefits in RBC usage and post-procedure hematocrit levels.
  • The study concluded that IHD-RCE is safe and can lead to lower RBC requirements and higher hematocrit levels, suggesting its wider application amid ongoing supply challenges for blood products.

Article Abstract

Background: The Spectra Optia allows automated performance of red blood cell reduction and isovolemic hemodilution (IHD) prior to standard red cell exchange (RCE), and is primarily intended for patients with sickle cell disease (SCD) undergoing chronic RCE. Data on the safety of inducing transient further anemia and the benefits of IHD-RCE is limited and occasionally contradictory.

Study Design And Methods: In this retrospective crossover analysis of six patients with SCD who underwent chronic exchange with standard RCE (Cobe Spectra) followed by IHD-RCE (Spectra Optia), we compared safety and benefit outcomes with IHD-RCE vs standard RCE.

Results: There were statistically but not clinically significant drops in blood pressure in the post-IHD phase. With IHD-RCE, there were significant reductions in red blood cell (RBC) usage and/or lower fraction of cells and significant increases in postprocedure hematocrit (Hct) associated with increased preprocedure Hct. There were no differences achieved in the time interval between procedures or in the net RBC gain with IHD-RCE. Overall, there were also no significant differences in pre- and postprocedure percentage of hemoglobin S, reticulocyte count, interval daily hemoglobin A decrement, or postprocedure white blood cell, neutrophil, or platelet counts.

Conclusions: Our study supports that IHD-RCE can be safely used in patients with stroke risk and compared to standard RCE, results in benefits of lower RBC usage and/or fraction of cells remaining and higher postprocedure Hct associated with higher preprocedure Hct. These findings support wider use of IHD-RCE, especially in the current environment with reduced availability of minority units.

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Source
http://dx.doi.org/10.1111/trf.16225DOI Listing

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