Automated red cell exchange in acute sickle cell crises: Case series and review of the literature

Automated red cell exchange (erythrocytapheresis) offers rapid suppression of circulating hemoglobin S without adding iron burden and is increasingly used to escalate care in acute sickle cell disease complications. This study describes four patients with severe vaso-occlusive crisis and/or acute chest syndrome managed with automated red cell exchange in a tertiary-care intensive care unit in India and summarizes Indian reports on its feasibility and on early outcomes. In the Indian scenario, this therapy is underutilized mostly due to the limited-resource setting, non-affordability, and probable lack of awareness of its availability.