{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T19:52:40Z","timestamp":1781898760489,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Optimal targets for red blood cell exchange (RCE) are not well defined in the chronic management of sickle cell disease. We analysed transfusion requirements and iron\u2010related outcomes in 101 patients on chronic RCE with a post\u2010procedure haematocrit (Ht) targeted at 34%, which is higher than typically used. A majority were of HbSS\/HbS\u03b20 genotype (<jats:italic>n<\/jats:italic>\u2009=\u200972) and enrolled for neurological complications (<jats:italic>n<\/jats:italic>\u2009=\u200953). Fifty patients had a positive Ht balance with RCE (&gt;2% mean increase from pre\u2010procedure level), while 43 patients maintained a neutral balance. The first group required fewer red blood cell units\/year (65 vs. 80, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), but a significant proportion were iron overloaded based on R2* with liver MRI (32% vs. none performed) and prescription of iron chelation (52% vs. 0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, after a median of 19\u2009months). The second group was more likely to receive iron supplementation (6% vs. 56%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Chronic automated RCE with a post\u2010procedure Ht targeted at 34% is not iron\u2010neutral, and personalized Ht goals may be more appropriate in certain settings. This higher target should be compared with a lower Ht strategy in individuals with similar baseline red cell volumes to assess iron homeostasis and blood product requirements.<\/jats:p>","DOI":"10.1111\/bjh.19674","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T02:59:53Z","timestamp":1722394793000},"page":"1556-1564","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Automated red blood cell exchange with a post\u2010procedure haematocrit targeted at 34% in the chronic management of sickle cell disease"],"prefix":"10.1111","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5002-7719","authenticated-orcid":false,"given":"Jules","family":"M.\u00a0Ross","sequence":"first","affiliation":[{"name":"Hematology\u2010Oncology Division, Departement of Medicine Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montreal 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