What are red blood cells?
Blood consists of different types of blood cells, including red blood cells. Red blood cells carry oxygen and carbon dioxide (CO₂) throughout the body.
What is a red blood cell exchange?
This technique aims to remove your red blood cells from your blood and replace them with healthy donor cells.
During the procedure, the different blood cells and plasma are separated. The red blood cells are collected and removed. The other blood cells and plasma are returned immediately, along with donor red blood cells.
The patient's own red blood cells are thus partially replaced by donor cells.
Typically, four to five bags of red blood cells are used.
When is a red blood cell exchange needed?
Certain conditions cause abnormal red blood cells to circulate in the blood. These cells have an abnormal shape, size, and function, which hinders the transport of oxygen throughout the body. As a result, not enough oxygen reaches the body’s tissues, which can damage cells and organs and cause pain or anaemia, for example.
A red blood cell exchange that removes and replaces the abnormal red blood cells can help prevent these negative effects.
How does a red blood cell exchange work?
The procedure is carried out using a cell separator, where a centrifuge separates the different components of the blood.
- A vein is punctured in the crease of one arm. An infusion needle is placed there for the blood collection. You must keep this arm straight during the entire procedure.
- The other arm receives a needle for the return of the blood. You can usually move this arm.
- An anticoagulant is used during the collection to prevent the blood from clotting in the tubing. The blood and anticoagulant are sent to the centrifuge.
- In the centrifuge, the red blood cells are separated from the other blood cells and sent to a collection bag. The other blood cells and plasma are returned to you along with the donor cells via the return infusion.
Tip
Preferably wear comfortable and easy clothing with short sleeves.
What might you experience during a red blood cell exchange?
- During the procedure, a small amount of blood is present in the tubing of the cell separator. Some people may feel slightly dizzy or light-headed as a result. Inform a nurse immediately if you feel unwell.
- A small amount of the anticoagulant may enter your bloodstream, which can cause tingling around the mouth or pins-and-needles in the hands or feet. Notify a nurse immediately if you notice any of these symptoms.
- You may feel cold because the blood is slightly cooled in the machine. Feel free to ask the nurse for a blanket.
- Donor red blood cells are used as replacement fluid, which may cause an allergic reaction (e.g. itching, redness, shortness of breath, sweating, etc.).
Frequently asked questions
You do not need to fast. On the contrary, it is better to eat something before the red blood cell exchange. We also recommend drinking plenty of fluids in the days leading up to the procedure.
During the procedure, you may also eat and drink using the arm that you are still allowed to bend.
It is best to go to the toilet before the procedure starts.
The procedure takes 2 to 2.5 hours.
Apart from inserting the infusion needles, the procedure is painless. The arm used for the blood collection must remain stretched and may not be bent during the procedure, which may feel uncomfortable.
Most people do not experience any side effects during or after the procedure. You may, however, feel a bit more tired afterwards. That’s why we recommend — especially for your first time — not to drive yourself home and to arrange for someone to accompany you.
You will have access to a personal television screen at Dagziekenhuis 10. You may also use your own laptop, smartphone, or tablet (free hospital wifi), or read a book or magazine, listen to music, etc.
If you want to watch or listen to something, please bring your own headphones or earphones. Note: Bluetooth connection is not available. You can only use wired headphones or earphones (jack plug).
You are welcome to bring someone to keep you company during the red blood cell exchange. A nurse is always present in the apheresis room.
The number and frequency of red blood cell exchanges depend on your condition and any symptoms you may have. Your treating physician will discuss this with you.
The procedure is usually repeated on a monthly basis.