{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:14:28Z","timestamp":1792088068779,"version":"4.4.0"},"reference-count":46,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Blood transfusion remains an important therapeutic intervention in patients with sickle cell disease (SCD), aiming to both increase the oxygen carrying capacity of blood and to reduce the complications of vaso-occlusion. Simple, manual exchange and automated exchange can be effective in reducing the acute and chronic complications of SCD, and the advantages and disadvantages of each methodology mean they all have a role in different situations. Evidence for the role of emergency transfusion in the management of the acute complications of SCD, including acute pain and acute chest syndrome, comes from observational data. Several important randomized controlled trials have shown the efficacy of transfusion in primary and secondary stroke prevention in patients with SCD but, outside these areas, clinical practice lacks a clear evidence base. Evidence for the role of long-term transfusion in the prevention of the non-neurologic chronic complications of SCD comes from analysis of secondary outcomes of these randomized trials and from observational data. In view of the paucity of data, the risks and benefits of transfusion should be fully discussed with patients\/families before a long-term transfusion program is commenced. Evidence is only available for the role of preoperative transfusion or for prophylactic transfusion through pregnancy in certain situations, and the role of transfusions outside these situations is discussed. Questions about when and how to transfuse in SCD remain and will need further randomized trials to provide answers.<\/jats:p>","DOI":"10.1182\/asheducation-2016.1.625","type":"journal-article","created":{"date-parts":[[2016,12,2]],"date-time":"2016-12-02T11:05:27Z","timestamp":1480676727000},"page":"625-631","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":163,"title":["Sickle cell disease: when and how to transfuse"],"prefix":"10.1182","volume":"2016","author":[{"given":"Jo","family":"Howard","sequence":"first","affiliation":[{"name":"Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; and King's College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"6","key":"2019111704390706900_B1","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1111\/j.1365-2141.2010.08451.x","article-title":"Blood transfusion usage among adults with sickle cell disease - a single institution experience over ten years","volume":"152","author":"Drasar","year":"2011","journal-title":"Br J Haematol"},{"issue":"11","key":"2019111704390706900_B2","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1002\/pbc.24630","article-title":"Trends in blood transfusion among hospitalized children with sickle cell disease","volume":"60","author":"Raphael","year":"2013","journal-title":"Pediatr Blood Cancer"},{"issue":"1","key":"2019111704390706900_B3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1056\/NEJM199807023390102","article-title":"Prevention of a first stroke by transfusions in children with sickle cell anemia and abnormal results on transcranial Doppler ultrasonography","volume":"339","author":"Adams","year":"1998","journal-title":"N Engl J Med"},{"issue":"26","key":"2019111704390706900_B4","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1056\/NEJMoa050460","article-title":"Discontinuing prophylactic transfusions used to prevent stroke in sickle cell disease","volume":"353","author":"Adams","year":"2005","journal-title":"N Engl J Med"},{"issue":"17","key":"2019111704390706900_B5","doi-asserted-by":"crossref","first-page":"3925","DOI":"10.1182\/blood-2011-11-392340","article-title":"Stroke With Transfusions Changing to Hydroxyurea (SWiTCH)","volume":"119","author":"Ware","year":"2012","journal-title":"Blood"},{"issue":"8","key":"2019111704390706900_B6","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1056\/NEJMoa1401731","article-title":"Controlled trial of transfusions for silent cerebral infarcts in sickle cell anemia","volume":"371","author":"DeBaun","year":"2014","journal-title":"N Engl J Med"},{"issue":"10019","key":"2019111704390706900_B7","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/S0140-6736(15)01041-7","article-title":"Hydroxycarbamide versus chronic transfusion for maintenance of transcranial doppler flow velocities in children with sickle cell anaemia-TCD With Transfusions Changing to Hydroxyurea (TWiTCH): a multicentre, open-label, phase 3, non-inferiority trial","volume":"387","author":"Ware","year":"2016","journal-title":"Lancet"},{"key":"2019111704390706900_B8","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1111\/bjh.13294","article-title":"Howard J, Telfer P. 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