American society for apheresis guidelines support use of red cell exchange transfusion for severe malaria with high parasitemia.

The American Society for Apheresis (ASFA) Special Issue Writing Committee read the article “Exchange transfusion for severe malaria: evidence base and literature review” by Tan et al with much interest [1]. The article concludes that exchange transfusion (ET) is not indicated in the setting of severe malaria. This recommendation contrasts with our evidence-based review, which supports ET as an adjunctive therapy.Tan et al's conclusion was based on analysis of cases of severe malaria reported to the US National Malaria Surveillance System from 1985 to 2010, supported by a literature review.