PMID- 35004720 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220111 IS - 2296-858X (Print) IS - 2296-858X (Electronic) IS - 2296-858X (Linking) VI - 8 DP - 2021 TI - Priming With Red Blood Cells Allows Red Blood Cell Exchange for Sickle Cell Disease in Low-Weight Children. PG - 743483 LID - 10.3389/fmed.2021.743483 [doi] LID - 743483 AB - Red blood cell exchanges are frequently used to treat and prevent cerebrovascular complications in patients with sickle cell anemia (SCA). However, the low weight of young children represents serious concerns for this procedure. The Spectra Optia device can perform automatic priming using red blood cells (RBCs) (RCE/RBC-primed) which could allow RBC exchanges (RCE) to be performed in young children without hypovolemic complications, but this method requires evaluation. We prospectively analyzed the clinical safety of the RCE/RBC-primed procedure in 12 SCA low-weight children under either a chronic RCE program or emergency treatment over 65 sessions. We monitored grade 2 adverse events (AEs) such as a decrease in blood pressure, increase in heart rate, fainting sensation, or transfusion reactions and identified the critical times during the sessions in which AEs could occur. Post-apheresis hematocrit (Hct) and a fraction of cell remaining (FCR) values were compared to the expected values. We also compared the impact of automatic RCE (n = 7) vs. RCE/RBC-primed (n = 8) on blood viscosity and RBC rheology. A low incidence of complications was observed in the 65 RCE sessions with only seven episodes of transient grade 2 AEs. Post-apheresis Hct and FCR reached expected values with the RCE/RBC-primed method. Both the automatic and priming procedures improved RBC deformability and decreased the sickling tendency during deoxygenation. Blood rheological features improved in both RCE/RBC-primed and automatic RCE without priming conditions. The RCE/RBC-primed procedure provides blood rheological benefits, and is safe and efficient to treat, notably in young children with SCA in prophylactic programs or curatively when a SCA complication occurs. CI - Copyright (c) 2021 Hequet, Boisson, Joly, Revesz, Kebaili, Gauthier, Renoux, Creppy, Nader, Nicolas, Berard, Cognasse, Vocanson, Bertrand and Connes. FAU - Hequet, Olivier AU - Hequet O AD - Etablissement Francais du Sang Rhone Alpes, Apheresis Unit, Centre Hospitalier Lyon Sud, Lyon, France. AD - CIRI, International Center for Infectiology Research, INSERM U1111, Universite de Lyon, Lyon, France. FAU - Boisson, Camille AU - Boisson C AD - Laboratoire Interuniversitaire de Biologie de la Motricite (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Universite Claude Bernard Lyon 1, Lyon, France. AD - Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France. AD - Service de Biochimie et Biologie Moleculaire, Laboratoire de Biologie Medicale Multi-site, Hospices Civils de Lyon, Lyon, France. FAU - Joly, Philippe AU - Joly P AD - Laboratoire Interuniversitaire de Biologie de la Motricite (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Universite Claude Bernard Lyon 1, Lyon, France. AD - Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France. AD - Service de Biochimie et Biologie Moleculaire, Laboratoire de Biologie Medicale Multi-site, Hospices Civils de Lyon, Lyon, France. FAU - Revesz, Daniela AU - Revesz D AD - Etablissement Francais du Sang Rhone Alpes, Apheresis Unit, Centre Hospitalier Lyon Sud, Lyon, France. FAU - Kebaili, Kamila AU - Kebaili K AD - Laboratoire Interuniversitaire de Biologie de la Motricite (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Universite Claude Bernard Lyon 1, Lyon, France. AD - Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France. AD - Institut d'Hematologie et d'Oncologie Pediatrique, Hospices Civils de Lyon, Lyon, France. FAU - Gauthier, Alexandra AU - Gauthier A AD - Laboratoire Interuniversitaire de Biologie de la Motricite (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Universite Claude Bernard Lyon 1, Lyon, France. AD - Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France. AD - Institut d'Hematologie et d'Oncologie Pediatrique, Hospices Civils de Lyon, Lyon, France. FAU - Renoux, Celine AU - Renoux C AD - Laboratoire Interuniversitaire de Biologie de la Motricite (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Universite Claude Bernard Lyon 1, Lyon, France. AD - Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France. AD - Service de Biochimie et Biologie Moleculaire, Laboratoire de Biologie Medicale Multi-site, Hospices Civils de Lyon, Lyon, France. FAU - Creppy, Severine AU - Creppy S AD - Distribution Unit, Centre Hospitalier Edouard Herriot, Etablissement Francais du Sang Auvergne Rhone Alpes, Lyon, France. FAU - Nader, Elie AU - Nader E AD - Laboratoire Interuniversitaire de Biologie de la Motricite (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Universite Claude Bernard Lyon 1, Lyon, France. AD - Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France. FAU - Nicolas, Jean Francois AU - Nicolas JF AD - CIRI, International Center for Infectiology Research, INSERM U1111, Universite de Lyon, Lyon, France. AD - Clinical Immunology and Allergology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France. FAU - Berard, Frederic AU - Berard F AD - CIRI, International Center for Infectiology Research, INSERM U1111, Universite de Lyon, Lyon, France. AD - Clinical Immunology and Allergology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France. FAU - Cognasse, Fabrice AU - Cognasse F AD - Scientific Department, Etablissement Francais du Sang Auvergne-Rhone-Alpes, Saint-Etienne, France. FAU - Vocanson, Marc AU - Vocanson M AD - CIRI, International Center for Infectiology Research, INSERM U1111, Universite de Lyon, Lyon, France. FAU - Bertrand, Yves AU - Bertrand Y AD - Institut d'Hematologie et d'Oncologie Pediatrique, Hospices Civils de Lyon, Lyon, France. FAU - Connes, Philippe AU - Connes P AD - Laboratoire Interuniversitaire de Biologie de la Motricite (LIBM) EA7424, Equipe "Biologie Vasculaire et du Globule Rouge", Universite Claude Bernard Lyon 1, Lyon, France. AD - Laboratoire d'Excellence Sur le Globule Rouge (Labex GR-Ex), Paris, France. LA - eng PT - Journal Article DEP - 20211222 PL - Switzerland TA - Front Med (Lausanne) JT - Frontiers in medicine JID - 101648047 PMC - PMC8729904 OTO - NOTNLM OT - blood rheology OT - low weight children OT - performances OT - priming OT - red blood cell exchange OT - safety OT - sickle cell anemia COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/01/11 06:00 MHDA- 2022/01/11 06:01 PMCR- 2021/12/22 CRDT- 2022/01/10 09:26 PHST- 2021/07/18 00:00 [received] PHST- 2021/10/29 00:00 [accepted] PHST- 2022/01/10 09:26 [entrez] PHST- 2022/01/11 06:00 [pubmed] PHST- 2022/01/11 06:01 [medline] PHST- 2021/12/22 00:00 [pmc-release] AID - 10.3389/fmed.2021.743483 [doi] PST - epublish SO - Front Med (Lausanne). 2021 Dec 22;8:743483. doi: 10.3389/fmed.2021.743483. eCollection 2021.