Blood transfusions can be life saving for individuals with sickle cell disease (SCD); however, patients with SCD are at an increased risk for serious transfusion reactions, especially delayed hemolytic transfusion reactions. Avoiding unnecessary transfusions is critical. Standard hemoglobin thresholds used in the general population (e.g. 70 g/L) do not apply to patients with SCD. Patients with SCD generally have lower baseline hemoglobin levels and may develop hyperviscosity complications from transfusion. The need for transfusion in SCD should be determined in concert with national guidelines; the decision should involve hemoglobinopathy or hematology providers and/or transfusion medicine physicians.
Sources:
The Canadian Hemoglobinopathy Association. Sickle Cell Disease Consensus statement. [Internet] 2025 [cited 2026].
Davis B, et al. Guidelines on red cell transfusion in sickle cell disease Part II: indications for transfusion. Br J Haematol 2017;176(2):192-209. PMID: 27858994.
Raza S, et al. Red Cell Transfusion in General Medicine Patients at Teaching and Non-teaching Hospitals: A Retrospective Cohort Analysis. J Gen Intern Med. 2026 Jan;41(2):311-320. Epub 2025 Oct 28. PMID: 41152565.