ArticleJournal of magnetic resonance imaging : JMRI2019
Differential cerebral hemometabolic responses to blood transfusions in adults and children with sickle cell anemia.
Article in Journal of magnetic resonance imaging : JMRI, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 39 citations in OpenAlex.
- Effect of voxelotor on cerebral perfusion and cerebral oxygen metabolism and cardiac stress in adult patients with sickle cell disease.American journal of hematology · 2025Trial
- The influence of voxelotor on cerebral blood flow and oxygen extraction in pediatric sickle cell disease.Blood · 2024Trial
- Cerebral oxygen metabolism in adults with sickle cell disease.American journal of hematology · 2020Trial
- Reliability of diffuse optical spectroscopies for evaluation of cerebral hemometabolic stress in children with sickle cell anemia.Biomedical optics express · 2026Article
- Review
- Observational
- Cerebral vascular shunting and oxygen metabolism in sickle cell disease.Blood advances · 2025Article
- Cerebral Hemodynamic Responses to Disease-Modifying and Curative Sickle Cell Disease Therapies.Neurology · 2025Article
- Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study.Annals of the Child Neurology Society · 2024Article
- Reversibility of Cognitive Deficits and Functional Connectivity With Transfusion in Children With Sickle Cell Disease.Neurology · 2024Article
- Cerebral hemodynamic changes after haploidentical hematopoietic stem cell transplant in adults with sickle cell disease.Blood advances · 2024Article
- Automatic Rejection based on Tissue Signal (ARTS) for motion-corrected quantification of cerebral venous oxygenation in neonates and older adults.Magnetic resonance imaging · 2024Article
- Impaired cerebrovascular reactivity in pediatric sickle cell disease using diffuse correlation spectroscopy.Biomedical optics express · 2023Article
- Red cell exchange transfusions increase cerebral capillary transit times and may alter oxygen extraction in sickle cell disease.NMR in biomedicine · 2023Article
- Article
- The Development of Neuroimaging Biomarkers for Cognitive Decline in Sickle Cell Disease.Hematology/oncology clinics of North America · 2022Review
- Cerebral oxygen extraction fraction MRI: Techniques and applications.Magnetic resonance in medicine · 2022Review
- Cerebral oxygen metabolic stress is increased in children with sickle cell anemia compared to anemic controls.American journal of hematology · 2022Article
- Procedural adverse events in pediatric patients with sickle cell disease undergoing chronic automated red cell exchange.Transfusion · 2022Article
- Characterizing Intracranial Hemodynamics in Sickle Cell Anemia: Impact of Patient-Specific Viscosity.Cardiovascular engineering and technology · 2022Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundBlood transfusions are administered to children and adults with sickle cell anemia (SCA) for secondary stroke prevention, or as treatment for recurrent pain crises or acute anemia, but transfusion effects on cerebral hemodynamics and metabolism are not well-characterized. PURPOSE: To compare blood transfusion-induced changes in hemometabolic parameters, including oxygen extraction fraction (OEF) and cerebral blood flow (CBF), within and between adults and children with SCA. STUDY TYPE: Prospective, longitudinal study. SUBJECTS: Adults with SCA (n = 16) receiving simple (n = 7) or exchange (n = 9) transfusions and children with SCA (n = 11) receiving exchange transfusions were scanned once when hematocrit was near nadir and again within 7 days of transfusion. Adult controls without SCA or sickle trait (n = 7) were scanned twice on separate days. FIELD STRENGTH/SEQUENCE: 3.0T T ASSESSMENT: Global OEF was computed as the relative difference between venous oxygenation (from TRUST) and arterial oxygenation (from pulse oximetry). Global CBF was computed as total blood flow to the brain normalized by intracranial tissue volume. STATISTICAL TESTS: Hemometabolic variables were compared using two-sided Wilcoxon signed-rank tests; associations were analyzed using two-sided Spearman's correlation testing.
resultsIn adults with SCA, posttransfusion OEF = 0.38 ± 0.05 was lower (P = 0.001) than pretransfusion OEF = 0.45 ± 0.09. A change in OEF was correlated with increases in hematocrit (P = 0.02; rho = -0.62) and with pretransfusion hematocrit (P = 0.02; rho = 0.65). OEF changes after transfusion were greater (P = 0.002) in adults receiving simple versus exchange transfusions. Posttransfusion CBF = 77.7 ± 26.4 ml/100g/min was not different (P = 0.27) from pretransfusion CBF = 82.3 ± 30.2 ml/100g/min. In children with SCA, both posttransfusion OEF = 0.28 ± 0.04 and CBF = 76.4 ± 26.4 were lower than pretransfusion OEF = 0.36 ± 0.06 (P = 0.004) and CBF = 96.4 ± 16.5 (P = 0.004). DATA
conclusionCerebral OEF reduces following transfusions in adults and children with SCA. CBF reduces following transfusions more often in children compared to adults, indicating that vascular reserve capacity may remain near exhaustion posttransfusion in many adults. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage 5 J. Magn. Reson. Imaging 2019;49:466-477.
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