Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2016 | Month : May | Volume : 10 | Issue : 5 | Page : EC28 - EC30

Study of Twenty One Cases of Red Cell Exchange in a Tertiary Care Hospital in Southern India

M. Joshua Daniel, Prakash H Muddegowda, Chezhian Subash, Jyothi B Lingegowda, Niranjan Gopal, Krishna Prasad

1. Associate Professor, Department of Transfusion Medicine, , Mahatma Gandhi Medical College and Research Institute, SBV, Pillaiyarkuppam, Puducherry, India. 2. Associate Professor, Department of Pathology, VMKV Medical College, Seeragapadi, Salem, Tamil Nadu, India. 3. Consultant Hematologist, MIOT International Hospital, Chennai, India. 4. Associate Professor, Department of Pathology, VMKV Medical College, Seeragapadi, Salem, Tamil Nadu, India. 5. Associate Professor, Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute, SBV, Pillaiyarkuppam, Puducherry, India. 6. Lt col- Graded Specialist Anesthesia, AMC, 425 FD Hospital, Poonch.

Correspondence Address :
Dr. M. Joshua Daniel,
Associate Professor, Department of Transfusion Medicine, Mahatma Gandhi Medical College and Research Institute,
SBV, Pillaiyarkuppam, Puducherry-607402, India.
E-mail: drjoshuadaniel@yahoo.com

Abstract

Introduction: Red Cell Exchange (RCE) is removal of a patient’s red blood cells while replacing with donor red blood cells either manually or using automated systems. RCE is beneficial in patients with Sickle Cell Disease (SCD) either during sickling crisis or prior to major surgical procedures to bring down the sickling percentage as high sickling percentage during prolonged anaesthesia may lead to vaso-occlusive crisis. It is also employed in patients infested with malaria and babesiosis where parasitic index remain high despite medical management. RCE is also tried as an adjuvant therapy in certain poisons like nitrobenzene and carbon monoxide when first line management fails.

Aim: To study the effectiveness, clinical outcome, challenges and complications of RCE in various clinical scenario and to understand how this procedure can be effectively utilized in the management of patients in Indian scenario.

Materials and Methods: This retro prospective study was conducted in tertiary care center in southern India which analyzed 21 RCE procedures performed on patients with different clinical conditions. Of the 21 RCE performed, 18 procedures were performed on patients with case of sickle cell disease, Two procedures were performed on patients infested with severe falciparum malaria and one procedure was performed on a patient with nitrobenzene poisoning. All procedures were performed using Spectra Optia® Apheresis System - Terumo BCT.

Results: All the 18 patients who underwent the RCE for sickle cell anaemia were admitted for hemi-arthroplasty for avascular necrosis of the head of femur. The average initial HbS levels were between 73-85% and post RCE it was brought down to 22-29% and was achieved in a single sitting in all the cases. Among the two patients infested with severe falciparum malaria, RCE helped in reducing the infestation rate. In case of nitrobenzene poisoning, RCE helped in improvement of oxygen saturation and patient showed significant improvement.

Conclusion: RCE is a safe and clinically effective therapeutic modality with very minimal to nil side effects. RCE is possibly underutilized therapy in developing world like India due to various reasons like inadequate awareness/ technical expertise, lack of equipments and facilities to identify the clinical conditions per se etc.

Keywords

Abnormal red blood cells, Malaria, Sickle cell disease

How to cite this article :

M. Joshua Daniel, Prakash H Muddegowda, Chezhian Subash, Jyothi B Lingegowda, Niranjan Gopal, Krishna Prasad. STUDY OF TWENTY ONE CASES OF RED CELL EXCHANGE IN A TERTIARY CARE HOSPITAL IN SOUTHERN INDIA. Journal of Clinical and Diagnostic Research [serial online] 2016 May [cited: 2018 Apr 24 ]; 10:EC28-EC30. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2016&month=May&volume=10&issue=5&page=EC28-EC30&id=7809

DOI and Others

DOI: 10.7860/JCDR/2016/13427.7809


Date of Submission: Feb 10, 2015
Date of Peer Review: Sep 03, 2015
Date of Acceptance: Feb 24, 2016
Date of Publishing: May 01, 2016


Financial OR OTHER COMPETING INTERESTS: None.

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