Exchange transfusion is the procedure which involves removal of patient’s blood completely and replacement with fresh blood or plasma of the donor. It is otherwise known as replacement transfusion. It is an important life-saving procedure carried out in conditions such as severe jaundice, sickle cell anemia, erythroblastosis fetalis, etc.


Procedure involves both removal and replacement of affected blood in stages. Exchange transfusion is carried out in short cycles of few minutes duration, as follows:

1. Affected person’s blood is slowly drawn out in small quantities of 5 to 20 mL, depending upon the age and size of the person and the severity of the condition.

2. Equal quantity of fresh, prewarmed blood or plasma is infused through intravenous catheter. This is

carried out for few minutes.

3. Catheter is left in place and the transfusion is repeated within few hours.

4. This procedure is continued till the whole or predetermined volume of blood is exchanged.


1. Hemolytic disease of the newborn (erythroblastosis fetalis).

2. Severe sickle cell anemia.

3. Severe polycythemia (replacement with saline, plasma or albumin).

4. Toxicity of certain drugs.

5. Severe jaundice in newborn babies, which does not respond to ultraviolet light therapy. Normally,

neonatal jaundice is treated by exposure to ultraviolet rays. It breaks down the bilirubin which is excreted

by liver.


Autologous blood transfusion is the collection and reinfusion of patient’s own blood. It is also called self

blood donation. The conventional transfusion of blood that is collected from persons other than the patient is called allogeneic or heterologous blood transfusion. Autologous blood transfusion is used for planned surgical procedures. Patient’s blood is withdrawn in advance and stored. Later, it is infused if necessary during surgery.

This type of blood transfusion prevents the transmission of viruses such as HIV or hepatitis B. It also

eliminates transfusion reactions.


Blood transfusion without precaution leads to transmission of blood-borne infections such as:

i. HIV

ii. Hepatitis B and A

iii. Glandular fever or infectious mononucleosis (acute infectious disease caused by Epstein-

Barr virus and characterized by fever, swollen lymph nodes, sore throat and abnormal


iv. Herpes (viral disease with eruption of small blister-like vesicles on skin or membranes)

v. Bacterial infections.


Fluids infused into the body instead of whole blood are known as blood substitutes.

Commonly used blood substitutes are:

1. Human plasma

2. 0.9% sodium chloride solution (saline) and 5% glucose

3. Colloids like gum acacia, isinglass, albumin and animal gelatin

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