Bibliographic information
GuidelineWHO consolidated guidelines for the management of common childhood illness: management of sickle-cell disease in children and adolescents
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD) and suspected acute symptomatic stroke, exchange transfusion is suggested rather than simple red blood cells (RBC) transfusion.
Recommended in favor
Conditional
Certainty of evidence
Very low
Notes and Remarks
- All children with suspected acute symptomatic stroke should receive prompt blood transfusion. Where exchange transfusion is not feasible or is delayed, simple RBC transfusion is an acceptable alternative.
- Simple transfusion should be administered with caution to avoid excessive increases in post-transfusion haemoglobin concentration, which may increase blood viscosity and worsen clinical outcomes.
- The choice between exchange and simple RBC transfusion should be guided by clinical urgency, local resource availability and the potential for improved outcomes with exchange transfusion, particularly in situations where rapid reduction of haemoglobin S is critical.