Exchange transfusion as an adjunct therapy in severe Plasmodium falciparum malaria: A meta-analysis

Mark S. Riddle*, Jeffrey L. Jackson, John W. Sanders, David L. Blazes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

146 Scopus citations


The efficacy of exchange transfusion as an adjunct treatment for severe falciparum malaria is controversial. No sufficiently powered, randomized, controlled study has been reported. We analyzed 8 studies that compared survival rates associated with adjunct exchange transfusion with those associated with antimalarial chemotherapy alone. Exchange transfusion was not associated with a higher survival rate than was antimalarial chemotherapy alone (odds ratio [OR], 1.2-95% confidence interval [CI], 0.7-2.1). However, patients who received transfusions had higher levels of parasitemia and more-severe malaria. Sensitivity analysis found that survival rates were higher among patients with partial immunity to malaria (OR, 0.5-95% CI, 0.2-1.2) than they were among patients with no immunity (OR, 2.1-95% CI, 0.9-4.8;P = .007). Exchange transfusion does not appear to increase the survival rate; however, there were significant problems with the comparability of treatment groups in the studies reviewed, and a randomized controlled trial is necessary to determine whether exchange transfusion is beneficial.

Original languageEnglish
Pages (from-to)1192-1198
Number of pages7
JournalClinical Infectious Diseases
Issue number9
StatePublished - 1 May 2002


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