Red Cell Exchange the Key to Treating Stubborn Sickle Cell Disease

Sickle cell disease affects mostly African Americans and it can cause chronic pain, plus the emotional distress and anxiety that go along with it. But breakthroughs are being made to treat the disease, the major one being red cell exchange

Say the physicians at Lymexico, red cell exchange is the current preferred method for treating people infected with blood borne parasites like Bartonella and Babesia. It’s also used in cases of extreme bacterial infection. The cell exchange therapy is said to be considered a first-line therapy procedure and consists mainly of aggressively diluting the percentage of pathogens in the blood.   

But red cell exchange is also found to be very effective in fighting the symptoms of sickle cell disease. According to a report by ASH Publications, while red cell exchange transfusions remain a highly effective therapy, they are still considered underutilized when it comes to treating the chronic symptoms of sickle cell disease. In a word, red cell exchange can potentially provide the oxygen carrying capability while reducing the blood’s viscosity or thickness. 

Also, aggressive red cell exchange if said to be useful when it comes to acute chest and multi-organ failures such as stroke and upper right quadrant syndrome.   

Blood Transfusion and Viscosity

Says AHS Publications, blood viscosity is said to be the key behind the management of red cell exchange transfusion when it comes to treating sickle cell disease. Viscosity slows blood movement and therefore provides a certain resistance to blood flow even when doctor’s apply pressure. For instance, the flow of liquid through a twisted tube is naturally slower than a straight tube which means a doubling of viscosity might affect the velocity of the red cell exchange even more.   

In medical terms, nonlaminar flow or what’s called “turbulent flow” through a plastic tube can vary, making turbulent flow slower and less likely to affect smaller vessels as opposed to larger ones. In simpler terms, red cell exchange must be treated differently according to both the patient and the disease or affliction being treated. Speed of blood flow, or the lack thereof, is key.  

Intense Red Cell Exchange

Medical experts say that red cell exchange is most useful in situations where it’s of paramount importance not to just provide oxygen but to decrease the complications that can come with sickle cell disease. Replacing sickle cells with normal cells is said to help prevent the vaso-occlusion that chronically plagues these patients. But it doesn’t reverse it altogether.  

Intense or active red cell exchange can also rapidly ease the decrease in liver processing bilirubin, the scavenging of nitric oxide in sickle cells, and damage to renal tubular cells. Of course, this is only a temporary, but still proving itself to be a welcome treatment. 

Stroke Prevention

Sickle cell disease, which can eventually lead to stroke, can be prevented if utilizing red cell exchange on a early intervention basis. In fact, transfusions are said to be a highly recommended therapy of vaso-occlusive stroke in children with sickle cell. 

The data is said to be limited, but red cell exchange can also be helpful in preventing stroke in adults afflicted with sickle cell. 

Prolonged Maintenance of Low S Levels

For those patients who are diagnosed with chronic low Hb S levels, red cell exchange can be useful. Studies show that the procedure keeps Hb S low and, in turn, can prevent primary and secondary stroke in sickle cell patients.  

Red cell exchange is also said to help prevent leg ulcers, priapism, and pulmonary hypertension. Without the red cell oxygen therapy, a person with sickle cell might not be able to go about performing everyday tasks due to severe and chronic pain. In fact, a simple red cell transfusion is not recommended for patients suffering constant pain. It just prologues the symptoms.   

Transfusion During Pregnancy

Simple preventive transfusion in patients who are pregnant was said not to be helpful. But automated red cell exchange proved differently. It provided excellent results, or so randomized studies show.   

But red cell exchange can be very effective in female patients who are experiencing acute increases in pain during their pregnancies. It’s also effective in those with preeclampsia. 

Some Cautions

Each red cell exchange machine or what’s also known as an apheresis machine, contains a certain amount of blood that’s used for processing. If the volume is more than 15 percent of the patient’s complete blood volume, a “blood prime” by which the blood actually backs up in the machine can occur. The best way to prevent this is to increase the amount of hemoglobin or a simple blood primer which will help in avoiding dangerous vascular problems. 

Also keep in mind, patients with sickle sell are often dehydrated which means it’s important for them to be constantly rehydrating during the red cell exchange transfusion. Also, patients should avoid eating any food after midnight prior to the procedure.

What all this medical jargon comes down to however, is this: if you are suffering from sickle cell disease and are in constant pain, consult your physician about red cell therapy. It might not only lessen your pain, but it will help precent stroke.