ReviewClinical infectious diseases : an official publication of the Infectious Diseases Society of America2013
Exchange transfusion for severe malaria: evidence base and literature review.
Review in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
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- Severe Plasmodium falciparum infection with multi-organ involvement in an asplenic patient: a case report.Malaria journal · 2026Article
- Blood group antigens and malaria susceptibility.Frontiers in cellular and infection microbiology · 2025Review
- Case Report: A Case of Bone Marrow Necrosis and Hyperinflammation in a 10-Year-Old Boy after Plasmodium falciparum Infection.The American journal of tropical medicine and hygiene · 2023Article
- Recent Advances in Imported Malaria Pathogenesis, Diagnosis, and Management.Current emergency and hospital medicine reports · 2023Review
- Parasite burden and red blood cell exchange transfusion for babesiosis.Journal of clinical apheresis · 2021Article
- ABO blood group should be considered and reported when red blood cell exchange transfusion is used to treat Plasmodiumfalciparum Malaria patients.Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine · 2020Article
- "Dual-gene" malaria-resistance: Therapeutically-rational exchange (T-REX) of group-O sickle trait and group-O C-traittrait red blood cells can be evaluated in Benin and Nigeria.Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · 2020Article
- Severe malaria. Current concepts and practical overview: What every intensivist should know.Intensive care medicine · 2020Review
- Emerging Tick-Borne Diseases.Clinical microbiology reviews · 2020Review
- Pathology's historic 2019 incoming residents: Why "the internationalization of pathology" may markedly advance transfusion medicine and cellular therapeutics.Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · 2020Article
- Red Blood Cells: Exchange, Transfuse, or Deplete.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2019Review
- Malaria in Children.Infectious disease clinics of North America · 2018Review
- Pathophysiology, clinical presentation, and treatment of coma and acute kidney injury complicating falciparum malaria.Current opinion in infectious diseases · 2018Review
- Adjunctive therapy for severe malaria: a review and critical appraisal.Malaria journal · 2018Review
- Manual exchange transfusion for severe imported falciparum malaria: a retrospective study.Malaria journal · 2018Article
- Malaria in Children.Pediatric clinics of North America · 2017Review
- Post-malaria neurological syndromes.Clinical medicine (London, England) · 2017Article
- Answer to February 2017 Photo Quiz.Journal of clinical microbiology · 2017Article
- Exchange transfusion for babesiosis when, how, and how long?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2016Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundExchange transfusion (ET) has biologic plausibility as an adjunct to antimalarial drugs in treating severe malaria and has been used for decades despite limited evidence of its efficacy in improving survival. We examined the efficacy of ET as an adjunct treatment for severe malaria using US surveillance data and reviewed the literature to update recommendations.
methodsPatients with severe malaria reported to the US national malaria surveillance system during 1985-2010 were matched, and survival outcomes were compared between patients receiving and not receiving ET. The literature review used search terms "severe malaria" and "exchange transfusion." Case reports and series, observational and case-control studies, and meta-analysis were included.
resultsOne hundred one patients receiving ET were matched to 314 patients not receiving ET. There was no statistically significant association between ET and survival outcome (odds ratio, 0.84; 95% confidence interval, .44-1.60). We found 87 articles, mostly case reports or series, showing successful use of ET, likely reporting bias. There were 12 comparative studies, most of which were retrospective cohort studies, underpowered with no significant differences in survival. A previously published meta-analysis of 8 comparative studies found no significant survival differences. Adverse events were rarely reported but included acute respiratory distress syndrome, ventricular fibrillation, and hypotension.
conclusionsDespite rapid parasite clearance times resulting from ET, there is no evidence for efficacy of ET as adjunctive therapy in severe malaria. Adjunct ET cannot be recommended. When rapidly acting antimalarials, specifically artemisinins, become more widely available, the biologic plausibility argument for ET will become less relevant.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.