Preprint Article Version 1 This version is not peer-reviewed

Red Blood Cell Exchange in children with Sickle Cell Disease in French Guiana

Version 1 : Received: 24 July 2020 / Approved: 26 July 2020 / Online: 26 July 2020 (02:22:35 CEST)

How to cite: Elenga, N.; Vantilcke, V.; Martin, E.; Cuadro, E.; Parisot, M.; Maire, F.; Selles, P.; Basset, T. Red Blood Cell Exchange in children with Sickle Cell Disease in French Guiana. Preprints 2020, 2020070627 (doi: 10.20944/preprints202007.0627.v1). Elenga, N.; Vantilcke, V.; Martin, E.; Cuadro, E.; Parisot, M.; Maire, F.; Selles, P.; Basset, T. Red Blood Cell Exchange in children with Sickle Cell Disease in French Guiana. Preprints 2020, 2020070627 (doi: 10.20944/preprints202007.0627.v1).

Abstract

The aim of our study was to describe our experience using a Spectra Optia® automated apheresis system in children with sickle cell disease (SCD). We used automated red blood cell exchange (RCE) to treat acute and chronic complications in 75 children with SCD who had a median age of 10 years [7-13]. We analysed 649 exchange sessions. Peripheral venous access was limited in a number of the children, thus requiring a femoral central double‐lumen venous catheter (CVC). We recommend the use of heparin locking, with 500 units in each lumen of a CVC. This method was well tolerated, with few complications during the procedures. For preoperative prevention, all of the patients had achieved a post-RCE HbS level of <30% since this is a mandatory condition imposed by the anaesthesiologist. With a post-RCE Hb level of approximately 10-11 g/dL, a blood exchange volume of ≥32 mL/kg, and an interval between each RCE procedure of ≤30 days, it was able to maintain the residual HbS level below 30%. Despite a target pre‐exchange HbS level of 47%, we did not encounter a single stroke recurrence. Erythrocytapheresis is useful and safe for children with SCD.

Subject Areas

Erythrocytapheresis; red blood cell exchange; sickle cell disease; target HbS level; heparin locking

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