Abstract
Therapeutic erythrocytapheresis (ET), and red blood cell exchange (RBCx) are procedures in which the patients' RBCs are either selectively removed (ET) or removed and replaced by allogenic donor RBCs (RBCx). ET is most commonly used for hematocrit reduction in patients with polycythemia vera. RBCx is primarily used for the treatment of sickle cell disease (SCD), although it has been useful in treating severe malaria or babesiosis. These procedures are relatively safe; however, when allogeneic RBCs are used as the replacement fluid, the patient is at risk for transfusion-associated adverse events, in addition to apheresis risks. Recently, a modified RBCx procedure performed on stable SCD patients, termed isovolemic hemodilution RBCx (or depletion RBCx), has been introduced in an effort to reduce RBC unit exposure. These procedures may also be performed manually; however, this chapter discusses only automated systems.
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