Blood transfusion usage among adults with sickle cell disease – a single institution experience over ten years

Drašar, Emma; Igbineweka, Norris; Vasavda, Nisha; Free, Matthew; Awogbade, Moji; Allman, Marlene; Mijović, Aleksandar; Thein, Swee Lay

doi:10.1111/j.1365-2141.2010.08451.x

Cited by 60 publications

(49 citation statements)

References 14 publications

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“…The observed difference may have been underestimated as the interval between transfusion and antibody screening was much larger in the episodic group and under detection of antibodies due to evanescence may have occurred [49,50]. In general, episodic transfusions are often given for treatment of acute pro-inflammatory complications such as an acute chest syndrome, or hemolytic or vasoocclusive crises [3,24,51]. The higher alloimmunization risk associated with episodic transfusions adds to the notion that RBC units given during acute, inflammatory events are associated with an increased risk for alloimmunization [24,52,53].…”

Section: Discussionmentioning

confidence: 99%

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Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

et al. 2016

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Red blood cell (RBC) alloimmunization is a major complication of transfusion therapy in sickle cell disease (SCD). Identification of high-risk patients is hampered by lack of studies that take the cumulative transfusion exposure into account. In this retrospective cohort study among previously non-transfused SCD patients in the Netherlands, we aimed to elucidate the association between the cumulative transfusion exposure, first alloimmunization and independent risk factors. A total of 245 patients received 11 952 RBC units. Alloimmunization occurred in 43 patients (18%), half of them formed their first alloantibody before the 8th unit. In patients with exposure to non-extended matched transfusions (ABO and RhD) the cumulative alloimmunization risk increased up to 35% after 60 transfused units. This was significantly higher compared to a general transfused population (HR 6.6, CI 4.2-10.6). Receiving the first transfusion after the age of 5 was an independent risk factor for alloimmunization (HR 2.3, CI 1.0-5.1). Incidental, episodic transfusions in comparison to chronic scheme transfusions (HR 2.3, CI 0.9-6.0), and exposure to non-extended matched units in comparison to extended matching (HR 2.0, CI 0.9-4.6) seemed to confer a higher alloimmunization risk. The majority of first alloantibodies are formed after minor transfusion exposure, substantiating suggestions of a responder phenotype in SCD and stressing the need for risk factor identification. In this study, older age at first transfusion, episodic transfusions and non-extended matched transfusions appeared to be risk factors for alloimmunization.

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Section: Discussionmentioning

confidence: 99%

“…This may be explained by the fact that part of our data derives from an era when such guidelines were not yet widely available. It has however been reported previously that transfusion therapy in SCD has expanded to indications for which the evidence is yet unclear [3].…”

Section: Discussionmentioning

confidence: 99%

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

et al. 2016

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“…8 The risk of hepatic siderosis is further likely to escalate with the increasing life span in SCD patients and cumulative exposure to transfused red cells.…”

Section: 3mentioning

confidence: 99%

How we treat sickle hepatopathy and liver transplantation in adults

Gardner

Suddle²,

Kane

et al. 2014

Blood

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Sickle cell disease (SCD) has evolved into a debilitating disorder with emerging end-organ damage. One of the organs affected is the liver, causing “sickle hepatopathy,” an umbrella term for a variety of acute and chronic pathologies. Prevalence of liver dysfunction in SCD is unknown, with estimates of 10%. Dominant etiologies include gallstones, hepatic sequestration, viral hepatitis, and sickle cell intrahepatic cholestasis (SCIC). In addition, causes of liver disease outside SCD must be identified and managed. SCIC is an uncommon, severe subtype, with outcome of its acute form having vastly improved with exchange blood transfusion (EBT). In its chronic form, there is limited evidence for EBT programs as a therapeutic option. Liver transplantation may have a role in a subset of patients with minimal SCD-related other organ damage. In the transplantation setting, EBT is important to maintain a low hemoglobin S fraction peri- and posttransplantation. Liver dysfunction in SCD is likely to escalate as life span increases and patients incur incremental transfusional iron overload. Future work must concentrate on not only investigating the underlying pathogenesis, but also identifying in whom and when to intervene with the 2 treatment modalities available: EBT and liver transplantation.

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“…One portion of each of the divided samples was used for crude aqueous extract ion (CAEI) process and the others were subjected to batchextraction procedures with butanol 6,7 . For the crude aqueous extraction of Helianthus annuus, one hundred (100) grams of the sample were soaked in 500 ml distilled water at 100 degrees centigrade for 12 hours, while for crude extracts of Arthrospira platensis and Monodora myristica, one hundred (100) grams of the sample were soaked in 200 ml distilled water at 100 degrees centigrade for 12 hours.…”

Section: Sample Preparationmentioning

confidence: 99%

Effects of Athrospira Platensis, Monodora Myristica and Helianthus Annuus on the Rate of Polymerization, Sickle Cell Reversion and Oxygen Affinity of Sickle Cell Hemoglobin

Nwaichi¹,

Monago²,

Amaraegbulem³

2013

J Pharm Sci Innov

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The in vitro effects of the cyanobacteria (Athrospira platensis), spices (Monodora myristica) and the achene (Hellianthus annuus) on the rate of polymerization, sickle cell reversion and oxygen affinity of sickle cell hemoglobin (HbS) was studied spectophotometrically using hemolysates of HbS containing erythrocytes treated with sodium metabisulphite in the presence of the different plant extracts. All fractions of the three plant extracts showed statistically significant decreases (p< 0.05) in the rate of polymerization therefore inhibited the rate of sickling with increasing time. The Benzene Soluble Extract (BESE) fraction of Hellianthus annuus demonstrated the highest antisickling activity (89.15% inhibition of HbSS), while the least was by the BESE fraction of Athrospira platensis (45.16% inhibition of HbSS). The crude aqueous extract (CAE) fraction of Athrospira platensis showed the highest antioxidant effect, while CAE fraction of Monodora myristica gave the least. The water soluble extract (WSE) fraction of Hellianthus annuus expressed maximum rate of sickling reversion. Alcohol extracts of these plants were found to exhibit a more significant antisickling activity relative to the aqueous extracts which is attributable to the presence of some lipophillic amino acids present in the alcoholic fraction of the extracts, and it could also be responsible for the observed high reversion capacity but low antioxidant effect of the lipophillic fraction of the plant extracts.

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Blood transfusion usage among adults with sickle cell disease – a single institution experience over ten years

Cited by 60 publications

References 14 publications

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

How we treat sickle hepatopathy and liver transplantation in adults

Effects of Athrospira Platensis, Monodora Myristica and Helianthus Annuus on the Rate of Polymerization, Sickle Cell Reversion and Oxygen Affinity of Sickle Cell Hemoglobin

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