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Catalog ID RBC Exchange Red Cell Exchange Procedure

CPOE Test Name

Use Blood Bank apheresis Administration Adult Subphase (Red Cell Exchange Procedure Order)


Therapeutic Erythrocytophersis, Red Blood Cell Exchange

Specimen Requirements

Pink top (EDTA) tube. Fenwal Label. Requires Full Name, Medical Record Number, date and phlebotomist initials/Cerner ID 


Consultation, Service Request and venous access is required.

Storage and Transport

Send Consultation and Service Request to Apheresis

Causes for Rejection

Consultation or Service Request not received or approved by Pathologist.


Patient: inadequate venous access (would require insertion of catheter by clinical service). 


Improper labeling; wrong tube; gross hemolysis; insufficient volume


Consult needs to be sent to Blood Bank Pathologist

Test Consists

Ordering physician must give Apheresis Service staff the following information when ordering procedure:

Patient height, weight, pre-procedure hematocrit, pre-procedure percent Hemoglobin S, post-procedure hematocrit target, post-procedure Hemoglobin S percent. Consult form should be completed at time of ordering and sent to Apheresis Service, Room BI 1220, for completion by Medical Director or Clinical Pathologist on call. Status of Apheresis treatment request will be determined by attending pathologist (Routine; Urgent: treatment within 24 hours; Emergency: treatment as soon as feasible).

Turn Around Time

Depends on patient tolerance.


Red cell exchange is a procedure using an automated apheresis machine. Whole blood is removed on continuous basis, separated by laminar flow centrifugation into red cell, buffy coat and plasma fractions. Patient red cells are diverted from returning to the patient and are replaced with crossmatch compatible donor red blood cells. Removed patient cells are discarded. Usual red cell exchange volume is calculated by apheresis machine software. The calculation is dependent on pre-procedure percent Hemoglobin S and target percent Hemoglobin S post-procedure set by the ordering clinician.



Reference Ranges

Not applicable

Performing Lab

Crossmatching: send to Blood Bank, BI-1230 721-2731

Procedure Scheduling: Apheresis Service, BI 1220, 721-3769