A nationally representative survey of 100 US providers found fewer than 3% of their sickle cell patients were recorded as receiving red blood cell exchange, while 91% reported access. Common barriers included coordination, limited donated blood and unfamiliarity.
Red blood cell exchange removes a patient's damaged red cells and returns the other blood components alongside donor red cells. Only 5% of surveyed providers reported no barriers to administering it. The survey also found that patients were concerned about whether insurance would cover the treatment.
Lead author Dr Aaron Haubner said expanding comprehensive sickle cell centers nationally could broaden access by bringing specialist services together. Dr Edward Donnell Ivy of the Sickle Cell Disease Association of America said roughly 80% of patients are on Medicaid and rural location can limit care. Dr Shannon Kelly of UCSF Benioff Children's Hospital Oakland said her hospital receives referrals from institutions without dedicated apheresis programs, and some patients travel long distances.
