A Palliative Care Approach in Treating Patients With Sickle Cell Disease Using Exchange Transfusion

The authors present a case report of an adult patient with sickle cell disease (SCD), who required frequent hospitalizations for sickle cell vaso-occlusive painful crisis as well as management of complications that resulted from treatment. The patient demonstrated clinical improvement after initiating palliative exchange transfusions of packed red blood cells (PRBCs) once every 4 weeks. They also promptly addressed their physical and psychosocial issues of care. The author described that because the patient was started on chronic exchange transfusions, there was a significant decrease in hospitalizations and emergency department (ED) visits. They saw a major improvement in the quality of life of this patient. The review of medical literature did not reveal any clear-cut guidelines for palliative chronic exchange transfusion for painful vaso-occlusive crisis in adult patients. This case review highlights the usefulness of this palliative model of care. The burden and benefits of chronic exchange transfusion always need to be weighed carefully.