2 Current practice

2 Current practice

NICE medical technologies guidance on the Spectra Optia Apheresis System for automated red blood cell exchange in patients with sickle cell disease describes the role of automated red cell exchange in managing sickle cell disease and should be referred to for further details.

The British Committee for Standards in Haematology guideline on the clinical use of apheresis procedures for the treatment of patients and collection of cellular therapy products recommends that elective red cell exchange should be considered in people with sickle cell disease for primary stroke prevention, secondary stroke prevention, elective surgery, painful crises in pregnancy, and in patients with severe disease who cannot have hydroxycarbamide.

The NHS sickle cell and thalassaemia screening programme, Sickle cell disease in childhood: standards and guidelines for clinical care, identifies the indications for regular long‑term transfusion as primary and secondary stroke prevention, recurrent acute chest syndrome not prevented by hydroxycarbamide and progressive organ failure. It also suggests that top‑up transfusions are the most common chronic transfusion therapy in paediatrics.

The West Midlands Quality Review Service overview report 2012/13 for adults with haemoglobin disorders noted inequity in access to automated exchange. Information from the sites indicated that where there is no access to automated exchange, those patients needing regular transfusions are offered a combination of top‑up transfusions and manual exchange.

This page was last updated: 02 March 2016