Health Encyclopedia

Exchange transfusion

Definition

Exchange transfusion is a potentially life-saving procedure that is done to counteract the effects of serious jaundice or changes in the blood due to diseases such as sickle cell anemia.

The procedure involves slowly removing the patient's blood and replacing it with fresh donor blood or plasma.

Description

An exchange transfusion requires that the patient's blood can be removed and replaced. In most cases, this involves placing one or more thin tubes, called catheters, into a blood vessel. The exchange transfusion is done in cycles, each one usually lasts a few minutes.

The patient’s blood is slowly withdrawn (usually about 5 to 20 mL at a time, depending on the patient’s size and the severity of illness). An equal amount of fresh, prewarmed blood or plasma flows into the patient's body. This cycle is repeated until the correct volume of blood has been replaced.

After the exchange transfusion, catheters may be left in place in case the procedure needs to be repeated.

In diseases such as sickle cell anemia, blood is removed and replaced with donor blood.

In conditions such as neonatal polycythemia, a specific amount of the child’s blood is removed and replaced with a normal saline solution, plasma, or albumin (the clear liquid portion of blood). This decreases the total number of red blood cells in the body and makes it easier for blood to flow through the body.

Indications

An exchange transfusion may be needed to treat the following conditions:

Neonatal polycythemia
Rh-induced hemolytic disease of the newborn
Severe disturbances in body chemistry
Severe newborn jaundice that does not respond to phototherapy with bili lights
Severe sickle cell crisis
Toxic effects of certain drugs

Risks

General risks are the same as with any transfusion. Other possible complications include:

Blood clots
Changes in blood chemistry (high or low potassium, low calcium, low glucose, change in acid-base balance in the blood )
Heart and lung problems
Infection (greatly decreased risk due to careful screening of blood)
Shock due to inadequate replacement of blood

Convalescence

The infant may need to be monitored for several days in the hospital after the transfusion, but the length of stay generally depends on the condition for which the exchange transfusion was performed.

Review Date:10/19/2007
Reviewed By:Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review Provided by VeriMed Healthcare Network.

ADAM Quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.