Chronic red cell transfusion plays an important role in the therapy of specific patient populations: those with insufficient erythropoiesis, stem cell disorders or thalassemic conditions and those with chronic hemolysis from hemoglobinopathies. Indications for chronic transfusion in these diverse populations are well defined for both children and adults, and will be reviewed in this audioconference. Chronic transfusion programs require many considerations not usually a part of acute transfusion practice: transfusion hemosiderosis, the long-term effects of red cell alloimmunization, consideration of "phenotype matching" and management of rare inventories, and the risk benefit of erythrocyte apheresis, to mention a few. The speakers will address these issues, along with the objectives of chronic transfusion in sickle cell disorders which differ from those for other patients. The role that alloimmunization to red cell antigens has in autoantibody formation and the increased hemolysis in sickle cell disease will also be addressed.