Wathsala Manindrani Gives a A Practical Perspective on Red Cell Exchange Transfusion
Wathsala Manindrani, Transfusion Medicine Senior Registrar at National Blood Trasfusion Service, Sri Lanka, shared on LinkedIn:
”Red Cell Exchange Transfusion: Automated vs Manual — A Practical Perspective
Red cell exchange transfusion (RCET) is a powerful therapeutic tool that allows rapid reduction of abnormal red cells while maintaining circulatory stability.
In day-to-day practice, especially in transfusion medicine, we commonly rely on two approaches: automated and manual red cell exchange.
Automated Red Cell Exchange
Automated exchange is performed using apheresis cell separators that selectively remove the patient’s red cells and replace them with donor packed red blood cells.
This method offers excellent precision, allowing us to target post-procedure haematocrit and abnormal cell burden accurately.
It is highly efficient, provides better hemodynamic stability, and significantly reduces iron overload when compared to repeated simple transfusions.
However, it requires specialised equipment, trained staff, reliable venous access, and higher resource investment.
Manual Red Cell Exchange
Manual exchange involves sequential phlebotomy followed by transfusion of donor red cells over multiple cycles.
While it is less precise and more time-consuming, it remains an important and practical option in settings where apheresis facilities are not readily available.
In many resource-limited environments, manual red cell exchange continues to be a lifesaving alternative.
Take-home message
Automated red cell exchange is the preferred method whenever resources allow, due to its safety, efficiency, and precision.
At the same time, manual red cell exchange ensures that effective care remains accessible across diverse healthcare settings — reminding us that adaptability is key in transfusion practice.”
Stay updated with Hemostasis Today.
-
Jan 26, 2026, 05:40Vicki Kopplin Offers Immediate Funding for People With Bleeding Disorders
-
Jan 26, 2026, 05:27Jill Storry on Alloimmune Hemolytic Disease of the Fetus And Newborn
-
Jan 26, 2026, 04:59Abdul Mannan: BDUC – 4 Letters That Make Many Haematologists Uncomfortable
-
Jan 26, 2026, 04:51Manoj Kumar Singh: Power In Me Foundation Celebrates 2026 as Year Of Rare
-
Jan 26, 2026, 04:40Heghine Khachatryan: Did You Know VWD Comprises 3 Main Types?
-
Jan 25, 2026, 15:57Céline Chapelle Shares Clinical Predictors From the API-CAT Trial
-
Jan 25, 2026, 15:42Francesco Lo Monaco on Heart Disease Starting Quiet While Your Labs Speak First
-
Jan 25, 2026, 15:25Muhammad Ibrahim on Efficacy and Safety of Extended DOACs Use in VTE
-
Jan 25, 2026, 15:08Tushar Pandey on Managing Thrombotic Thrombocytopenic Purpura