Back to Course

Evidenced Based Management: A Journey for Physicians

0% Complete
0/0 Steps
  1. Historical Perspective, Epidemiology, and Methodology
  2. Overview of the SCD guidelines and chapters
  3. Process and methodology
  4. Consensus Statements
  5. Clinical Practice Guidelines and the institute of Medicine
  6. Prevention of invasive infection
  7. Screening for Renal Disease
  8. Electrocardiogram Screening
  9. Screening for hypertension
  10. Screening for Retinopathy
  11. Screening for risk of stroke using neuroimaging
  12. Screening for Pulmonary disease
  13. Reproductive counseling
  14. Contraception
  15. Clinical Preventive services
  16. Immunizations
  17. Vaso-Occlusive Crisis
  18. Fever
  19. Acute Renal Failure
  20. Priapism
  21. Hepatobiliary Complications
  22. Acute Anemia
  23. Splenic Sequestration
  24. Acute Chest Syndrome
  25. Acute Stroke
  26. Multisystem Organ Failure
  27. Acute Ocular Conditions
  28. Chronic pain
  29. Avascular Necrosis
  30. Leg Ulcers
  31. Pulmonary Hypertension
  32. Renal Complications
  33. Stuttering/Recurrent Priapism
  34. Ophthalmologic Complications
  35. Summary of the Evidence
  36. Hydroxurea Treatment Recommendations
  37. Consensus Treatment Protocol and Technical remarks for the implementation of Hydroxyurea Therapy
  38. Indications for transfusions
  39. Recommendations for Acute and Chronic Transfusion Therapy
  40. Appropriate Management/ Monitoring
  41. Consensus Protocol for Monitoring Individuals on Chronic Transfusion Therapy
  42. Complications of Transfusions
  43. Recommendations for the Management and Prevention of Transfusion Complications
  44. New Research is Needed
  45. Data Systems That Meet the Highest Standards of Scientific Rigor Can Be Invaluable
  46. Improved Phenotyping is needed
  47. Broad collaborations for Research and Care
  48. Beyond Efficacy
  49. Look, Listen, Empathize and Ask
Lesson 41 of 49
In Progress

Consensus Protocol for Monitoring Individuals on Chronic Transfusion Therapy

SCFA_Coach September 25, 2023

Consensus Protocol for Monitoring Individuals on Chronic Transfusion Therapy

The following is a consensus protocol for the initiation and monitoring of patients on chronic transfusion therapy. It is understood that the recommended testing schedule may not be available to patients everywhere; therefore, this protocol should serve only asa helpful guide for transfusion management.

At Initiation
Obtain patient treatment history to include locations where prior transfusions were received and any adverse effects.
Notify the blood bank that the patient being initiated on chronic transfusion therapy has SCD. Ask the blood bank to contact hospitals where the patient reported receiving previous transfusion therapy to obtain transfusion information.
Obtain a RBC phenotype, type and screen, quantitative measurement of percent HbA and percent HbS, complete blood count (CBC), and reticulocyte count.
Inform the patient if he or she is alloimmunized, so that this information can be communicated as part of the patient’s self-reported medical history.

Suggested Evaluation Before Each Transfusion
CBC and reticulocyte count-This procedure is done to help guide the frequency and volume of transfusions. It is expected that, with effective chronic transfusion therapy, the patient’s bone marrow will be suppressed and the reticulocyte count should decrease, but the value may rise by the time of the next transfusion.
Quantitative measurement of percent HbA and percent HbS-This procedure is done to confirm the success of chronic transfusion therapy with achieving the target percent of HbS.
Type and screen-This is done to assess whether the patient has developed any new RBC antibodies from the prior transfusion.

Suggested Periodic Evaluations
Liver function tests annually or semiannually-Thesetests are done to follow liver function in individuals with iron overload.
Serum ferritin (SF) quarterly-This test is done to follow iron stores in individuals with iron overload;it can be helpful in evaluating compliance with chelation.
Screening for hepatitis C, hepatitis B,and HIV annually.
Evaluation for iron overload every 1-2 years by validated liver iron quantification methods such as liver biopsy, MRI R2 or MRI T2* or R2 techniques.


Your email address will not be published. Required fields are marked *