BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuExchange transfusionHemolytic disease - exchange transfusionExchange 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 person's blood and replacing it with fresh donor blood or plasma. Description An exchange transfusion requires that the person's blood 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 The exchange transfusion is done in cycles, each one most often lasts a few minutes.The person's blood is slowly withdrawn (most often about 5 to 20 mL at a time, depending on the person's size and the severity of illness). An equal amount of fresh, prewarmed blood or plasma flows into the person'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 (the clear liquid part of blood), or albumin (a solution of blood proteins). This decreases the total number of red blood cells in the body and makes it easier for blood to flow through the body.Neonatal polycythemiaPolycythemia can occur when there are too many red blood cells (RBCs) in an infant's blood.ImageRead Article Now Book Mark Article Why the Procedure Is Performed An exchange transfusion may be needed to treat the following conditions:Dangerously high red blood cell count in a newborn (neonatal polycythemia) Rh-induced hemolytic disease of the newborn Rh-induced hemolytic disease of the new...Rh incompatibility is a condition that develops when a pregnant woman has Rh-negative blood and the baby in her womb has Rh-positive blood.ImageRead Article Now Book Mark Article Severe disturbances in body chemistry Severe newborn jaundice that does not respond to phototherapy with bili lights Phototherapy with bili lightsBili lights are a type of light therapy (phototherapy) that is used to treat newborn jaundice. Jaundice is a yellow coloring of the skin and eyes. ...ImageRead Article Now Book Mark Article 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 (very low risk due to careful screening of blood) Shock if not enough blood is replaced After the Procedure The patient may need to be monitored for several days in the hospital after the transfusion. The length of stay depends on what condition the exchange transfusion was performed to treat.Open ReferencesReferencesCalihan J. Hematology. In: Kleinman K, Mcdaniel L, Molloy M, eds. Harriet Lane Handbook, The Johns Hopkins Hospital. 22nd ed. Philadelphia, PA: Elsevier; 2021:chap 14.Josephson CD, Sloan SR. Pediatric transfusion medicine. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 121.Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Blood disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 124.Watchko JF. Neonatal indirect hyperbilirubinemia and kernicterus. In: Gleason CA, Juul SE, eds. Avery's Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 84.AllVideoImagesTogExchange transfusion - seriesPresentation Exchange transfusion - seriesPresentation Related Information Newborn jaundice - discharge(Discharge) Review Date: 12/10/2021 Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.