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Therapeutic Apheresis
Red Blood Cell Exchange (RBCX)* Indication
Overview Procedures For Patients Webinar

Discover the value of RBCX for transfusion management of sickle cell disease (SCD) in adults and children.

Compared to simple transfusion and manual exchange, RBCX provides the following advantages:

Removes red blood cells (RBCs) containing hemoglobin S (HbS) and rapidly replaces them with healthy RBCs while maintaining isovolemia1,2,3,4,5
Manages iron overload and blood viscosity1,4,9
Controls HbS and hematocrit3,4,6,7,8
Compared to other transfusion therapies, I have found RBC exchange to be a more efficient method of maintaining a low hemoglobin S percentage with minimal iron loading. – Julie Kanter, MD
Director of Sickle Cell Research
Medical University of South Carolina, Charleston, SC

Spectra Optia® Apheresis System

Discover the value of RBCX for transfusion management of SCD patients.

Learn More
Procedures
RBCX for Transfusion Management of SCD
RBCs are removed and simultaneously replaced with healthy RBCs.
Depletion/ Exchange Procedure

The depletion/exchange procedure is a combination of the depletion and exchange phases. The behavior of the system during the depletion and exchange phases is the same as when each is performed as a stand-alone procedure.

Depletion Phase

First, the system performs the red blood cell (RBC) depletion to lower the patient's hematocrit (Hct) to a prescribed level while maintaining isovolemia. This is done by removing the patient's RBCs and replacing them with a non-cellular fluid such as saline.

Exchange Phase

Second, after the depletion phase is complete, the system performs the RBC exchange phase to increase the patient's Hct to the prescribed target Hct. This is done by removing the patient's RBCs and replacing them with healthy donor RBCs.

For Patients

RBCX Through Your Patient's Eyes

RBCX Calculation Tool

Estimate the volume of replacement fluid from your mobile device.

RBCX Clinical Trial

Prospective, multi-center, single-arm, open-label study to evaluate the performance of the Spectra Optia system RBCX protocols (exchange and depletion/exchange) in adults and children with sickle cell disease.

Safety Information

Contraindications

  • No known contraindications for the system's use, except for those associated with all automated apheresis systems
  • The infusion of certain solutions and replacement fluids may be contraindicated in some patients

Possible patient reactions

  • Anxiety, headache, light-headedness, digital and/or facial paresthesia, fever, chills, hematoma, hyperventilation, nausea and vomiting, syncope (fainting), urticaria, hypotension and allergic reactions

Reactions to transfused blood products can include1

  • Fever, circulatory overload, shock, allergic reactions, alloimmunization, graft-versus-host disease and transmission of infection

Restricted to prescription use only

  • Operators must be familiar with the system's operating instructions
  • Procedures must be performed by qualified medical personnel
  • A supervisory practitioner may supervise from a physician office or other nonhospital space that is not officially part of the hospital campus as long as he or she remains immediately available2

1AABB (ed.), et al., Circular of Information for the Use of Human Blood and Blood Components. 2006, tenth edition, Council of Europe Publishing, Seattle, WA.

2American Society for Apheresis, "Guidelines for Documentation of Therapeutic Apheresis Procedures in the Medical Record by Apheresis Physicians." Journal of Clinical Apheresis 2007; 22 (3): 183.

*Product and protocol availability varies by country.

1Adams D, et al., "Erythrocytapheresis can reduce iron overload and prevent the need for chelation therapy in chronically transfused pediatric patients." Journal of Pediatric Hematology-Oncology 1996; 18 (1): 46–50.

2Danielson C, et al., "The role of Red Blood Cell Exchange transfusion in the treatment and prevention of complications of sickle cell disease." Therapeutic Apheresis 2002; 6 (1): 24–31.

3Wahl S, et al., "Lower alloimmunization rates in pediatric sickle cell patients on chronic erythrocytapheresis compared to chronic simple transfusions." Transfusion 2012; 52 (12): 2671–2676.

4Lawson SE, et al., "Red cell exchange in sickle cell disease." Clinical & Laboratory Haemotology 1999; 21 (2): 99–102.

5Wayne S, et al., "Transfusion management of sickle cell disease." Blood 1993; 81 (5): 1109–1123.

6Cabibbo S, et al., "Chronic RBC exchange to prevent clinical complications in sickle cell disease." Transfusion Apheresis Science 2005; 32 (3): 315–321.

7Hilliard L, et al., "Erythrocytapheresis limits iron accumulation in chronically transfused SCD patients." American Journal of Hematology 1998; 59 (1): 28–35.

8Duclos C, et al., "Long-term red blood cell exchange in children with sickle cell disease: Manual or automatic?" Transfusion Apheresis Science 2013; 48 (2): 219–222.

9Singer S, et al., "Erythrocytapheresis for chronically transfused children with sickle cell disease: An effective method for maintaining a low HbS level and reducing iron overload." Journal of Clinical Apheresis 1999; 14 (3): 122–125.

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