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RBCX options: Exchange, depletion or both?


With the Spectra Optia® Apheresis System, you can choose one of three red blood cell exchange (RBCX) protocols, depending on an individual patient’s need and condition: Exchange, depletion, or combined depletion/exchange. We explain the differences to help you identify the right protocol for each situation.


Exchange: The most common RBCX protocol, this facilitates the exchange of patient red blood cells (RBCs) with donor RBCs.

Depletion: This option facilitates the exchange of patient RBCs with non-cellular replacement fluid, such as albumin or saline, to decrease the patient’s hematocrit (Hct).

Dep​letion/exchange: This protocol starts with a depletion phase and transitions to an exchange phase. During the depletion phase, the patient’s RBCs are removed without mixing with the donor RBCs. For some patients, this may mean that less replacement fluid is required than with just an exchange.

In addition, compared to a stand-alone exchange, a combined depletion/exchange may offer more benefits for some patients:
  • Less blood may be required to attain the desired fraction of cells remaining (FCR).
  • Fewer donor RBCs may be needed from the blood center to attain the same FCR, and there may be significantly less  exposure, over time, to donor RBCs.
  • A lower FCR may be achieved with the same volume of RBCs.
See examples below for more details.

   Considerations for Depletion/Exchange
Spectra Optia RBCX (V12) Training_Slide 47.png 

Terumo Blood and Cell Technologies. Red Blood Cell Exchange (V12 RBCX) Rx Only Procedure Training. 2023;(v5.0).


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