Complications
With the repeated transfusions required for chronic haemolytic anaemias, development of significant antibody burden against packed red blood cells may make cross-matching very difficult.
Restricting transfusions to symptomatic anaemia is important.
Unlikely with acquired haemolytic process, but common with hereditary haemolytic anaemias.
With the repeated transfusions required for chronic haemolytic anaemias, patients who are on a regular transfusion programme (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.[71]
Treatment of iron overload can be with desferrioxamine, deferiprone, or deferasirox.[71]
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