Complications
With the repeated transfusions required for chronic hemolytic anemias, development of significant antibody burden against packed red blood cells may make cross-matching very difficult.
Restricting transfusions to symptomatic anemia is important.
Unlikely with acquired hemolytic process, but common with hereditary hemolytic anemias.
With the repeated transfusions required for chronic hemolytic anemias, patients who are on a regular transfusion program (transfusions every three months or less) should be monitored for iron overload and complications of iron overload. Recommendations for evaluation of iron overload in chronically transfused patients include serum ferritin, hepatic iron assessment by quantitative magnetic resonance imaging, or liver biopsy annually and a yearly echocardiogram.[72]
Treatment of iron overload can be with desferrioxamine, deferiprone, or deferasirox.[72]
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