Red Cell Exchange

Apheresis experts at UT Southwestern offer red blood cell exchanges for patients in the Dallas-Fort Worth area and beyond.

Our team is committed to providing effective, personalized apheresis care for patients with sickle cell disease.

Effective Red Blood Cell Removal and Replacement

Red blood cell exchange (RBCx) is a nonsurgical therapy that removes abnormal red blood cells and replaces them with healthy red blood cells provided from blood donors. Removal and replacement of unhealthy red blood cells can improve certain conditions, leading to improvement of symptoms and quality of life.

UT Southwestern is a recognized leader in apheresis, offering both inpatient and outpatient services seven days a week. Our dedicated team of physicians, advanced practice providers, registered nurses, and certified apheresis technicians provides the most advanced care and uphold our institution’s mission of delivering the highest level of quality, safety, and service.

Additionally, our physicians actively participate in multicenter clinical trials that focus on breakthroughs such as using pathogen-inactivated red blood cells for RBCx. Such trials aim to further improve the quality and safety of blood transfused to our patients.

Red Cell Exchange: What to Expect

During RBCx, small amounts of blood are gradually removed through an inserted needle or central line catheter and circulated through a machine that separates the blood into red cells, white cells, platelets, and plasma.

The abnormal red blood cells are discarded and replaced with healthy red blood cells provided by a blood donor. The donor red blood cells are added back to the patient’s other blood components (white cells, platelets, and plasma) through a return access of either a needle or central line catheter.

In cases of sickle cell disease, procedures are typically performed every four to eight weeks to maintain an adequate number of healthy red cells. This helps prevent stroke, nonhealing ulcers, and frequent pain crises.

RBCx programs have helped reduced complications of the disease, including iron overload.

It is a safe procedure with few possible side effects.

Before RBCx

Prior to a procedure, we recommend that patients drink large amounts of noncarbonated, nonalcoholic beverages for a couple of days. We also recommend eating a meal prior to the scheduled procedure.

During RBCx

If intravenous catheters (IVs) are placed, patients’ arms will be propped on pillows, and they will be asked to squeeze their fist to help promote blood flow. Patients may experience bruising or discomfort where the IVs are placed. If a larger catheter or port is used instead, patients will have free use of their arms during the procedure.

The procedure typically lasts two to three hours but can be shorter or longer depending on a variety of factors.

After starting the procedure, patients may experience some mild numbness, tingling, light-headedness, or nausea. An apheresis staff member who specializes in the procedure will be with the patient during the entire treatment. Patients should tell their nurse of any side effects or symptoms they feel.

After RBCx

After the procedure is completed, patients may feel tired for the rest of the day. We recommend drinking plenty of liquids after the procedure. We also recommend that patients have a family member or friend give them a ride home.