Rheologic behavior of sickle and normal red blood cell mixtures in sickle plasma: implications for transfusion therapy

BACKGROUND:  Guidelines for transfusion in sickle cell disease usually define an upper hematocrit (Hct) limit of 0.30 to 0.35 to avoid blood hyperviscosity. In vitro viscosity studies of normal (AA) and sickle (SS) red blood cell (RBC) mixtures in buffer appear to confirm that this Hct limit is optimal for oxygen delivery to vascular beds as judged by the ratio of Hct to viscosity, with this ratio often termed “oxygen or RBC transport effectiveness.” In the absence of plasma, however, effects due to RBC‐RBC interactions mediated by plasma proteins cannot be assessed.

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