verivaihdon

Verivaihto, or verivaihdon, is a medical procedure in which part of a patient’s blood is removed and replaced with donor blood or blood components with the aim of quickly changing the blood’s composition. The term covers both exchange transfusion, where whole blood or red blood cells are exchanged, and blood-exchange approaches based on apheresis, in which components such as plasma or red cells are selectively removed and replaced. The goal is to reduce harmful substances, abnormal cells, or imbalances and to restore normal blood parameters.

The procedure is performed in hospital settings under the supervision of transfusion medicine or intensive care teams. In an exchange transfusion, blood is withdrawn and simultaneously replaced with donor blood, often using specialized equipment to monitor volumes and safety. In apheresis-based exchanges, a machine separates blood components and returns the appropriate portions to the patient while replacing others. Before the procedure, compatibility testing (such as ABO and Rh typing) and antibody screening are performed, and patients are closely monitored for vital signs, electrolyte balance, and transfusion reactions.

Indications for verivaihto vary and may include severe neonatal hyperbilirubinemia due to Rh or ABO incompatibility, to reduce bilirubin levels quickly; treatment considerations in certain cases of sickle cell disease to decrease concentrations of abnormal hemoglobin; and, in some poisonings or toxin exposures, rapid removal of circulating toxins. It is increasingly complemented by or used as an alternative to other exchange therapies, such as plasmapheresis, depending on the clinical situation.

Risks associated with verivaihto include transfusion reactions, electrolyte disturbances and calcium shifts related to anticoagulants, hypotension, volume overload, and infection risk from vascular access. The procedure is resource-intensive and requires careful patient selection, planning, and monitoring.