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Automated red blood cell exchange transfusion (erythrocytapheresis) is a therapeutic procedure being evaluated in the Phase 3 SCD-CARRE trial for high-risk adult patients with sickle cell disease (SCD) and cardiovascular complications. Led by the University of Pittsburgh and UPMC, the procedure involves the mechanical removal of a patient's sickled red blood cells and their simultaneous replacement with healthy donor red blood cells using an apheresis device. The goal is to maintain hemoglobin S levels below specific thresholds (typically <20-30%) to reduce the incidence of vaso-occlusive crises, organ damage, and mortality. Unlike simple transfusions, automated exchange allows for the removal of sickled cells without increasing blood viscosity or causing iron overload as rapidly.
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