Transfusion and sickle cell disease

Sickle cell disease is a hereditary pathology of the haemoglobin which affects only individuals from African ancestry. The frequency of the disease increases in France. Transfusion remains a major treatment of this disease. Depending of the indication, transfusion can be a simple transfusion or an exchange transfusion. In this last case, exchange can be performed manually or automatically. The transfusion protocols have to be adapted to the polytransfused status of these patients, but also to the high incidence of alloimmunisation against red blood cells. Alloimmunisation is a consequence of the polymorphism of blood groups between sickle cell disease patients and donors of European ancestry. Axes to optimize transfusion safety in these patients have to be developed. But the first step relies on the promotion of blood donation within individuals of African ancestry. (C) 2013 Elsevier Masson SAS. All rights reserved.