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Most US sickle cell patients miss out on effective red blood cell exchange

New research indicates that fewer than 3% of US sickle cell patients receive red blood cell exchange, despite widespread hospital access to the technology.

  • A red blood cell exchange is a procedure that replaces damaged red blood cells with donor cells.
  • A survey of 100 US healthcare providers found 91% reported access to the treatment, but under 3% of patients received it.
  • Barriers to treatment include coordination challenges, limited blood supply, and lack of familiarity with the procedure.

Many sickle cell patients in the United States are not receiving an effective treatment called red blood cell exchange, despite the technology being widely available in US hospitals, according to new research.

The procedure involves discarding a patient's damaged red blood cells and replacing them with red blood cells from a donor. A survey of 100 US healthcare providers who manage sickle cell patients found that while 91% reported access to this treatment, fewer than 3% of patients were recorded as receiving it.

Providers cited several barriers to administering the treatment, including difficulties coordinating between medical departments, a limited supply of donated blood, and a general lack of familiarity with the procedure. Only 5% of surveyed health providers reported no barriers to delivering this treatment.

For patients, a significant concern was whether red blood cell exchange therapy would be covered by their health insurance. Sickle cell disease, which affects over 100,000 people in the US and 8 million worldwide, primarily impacts people of colour.

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