The Cincinnati Comprehensive Sickle Cell Center proposes to continue and expand a high quality program which encompasses the components of research, patient surveillance, education, testing and counseling. The basic and clinical research projects which are all interrelated include investigations of infection and its prevention, the switch mechanism of fetal Hgb, viscosity, and the microcirculation, cardiorespiratory changes in sickle cell disease and the use of hypertransfusion. This combination of the basic and clinical research program, and the clinical evaluation and application related to patient surveillance and the evaluation of education training, testing and counseling; will promote correlation of results from research and feasibility for service. The Sickle Cell Center will also enable a concentration of resources and manpower to provide a program with many varied components in a coordinated fashion.