CASE REPORT |
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Year : 2020 | Volume
: 14
| Issue : 1 | Page : 70-73 |
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Red blood cell exchange in sickle cell disease patient with multiple alloantibodies
Geet Aggarwal1, Aseem Kumar Tiwari1, Pratibha Dhiman2, Dinesh Arora1, Swati Mehta Pabbi1, Divya Setya1
1 Department of Transfusion Medicine, Medanta – The Medicity, Gurgaon, Haryana, India 2 Department of Medical Oncology and Hematology, Medanta – The Medicity, Gurgaon, Haryana, India
Correspondence Address:
Dr. Aseem Kumar Tiwari Department of Transfusion Medicine, Medanta – The Medicity, Sector-38, Gurgaon - 122 001, Haryana India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ajts.AJTS_36_18
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There are several reports in medical literature about Red Cell Exchange (RCE) being routinely performed pre-operatively in sickle cell disease patients to provide immediate decrease in HbS concentration and prevent post-operative complications. We would like to present one such case of SCD who also had multiple allo-antibodies and had to undergo hemi-arthroplasty for avascular necrosis of head femur. Grouping and antibody screening was performed using column agglutination technique. 3-cell and 11- cell panel were used for antibody screening and identification, respectively. Automated RBC exchange was performed on apheresis machine Com.Tec using the standard PL1 kit (Fresenius Kabi, Germany). Multiple (anti-c, E) allo-antibodies were identified and successful pre-operative RCE was done with corresponding antigen-negative AHG compatible RBC units. Single RCE procedure reduced HbS concentration from 65% to 25%. The patient underwent uneventful hemi-arthroplasty and was discharged on post-operative day-7. Patient is on regular follow-up and continues to do well two months after the day of surgery. This is possibly the first case report from India, which illustrates successful automated RCE in a SCD patient with alloimmunization. |
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