The safety of avoiding transfusion preoperatively in patients with sickle cell hemoglobinopathies

Patients with Sickle Cell anemia (SCA) have higher chances of undergoing surgical procedures with higher morbidity. The practice of preoperative blood transfusion for such patients is still controversial. In this study we tried to assess the role of preoperative transfusion in patients with SCA. Between Jan. 1996 and Jun. 2001, a total of 369 patients, median age 16 (range: 1-35), underwent surgical procedures at KAUH or KFAFH. Surgical procedure included adenoidectomy, tonsillectomy, total hip arthroplasty, cholecystectomy, splenectomy, obstetric and gynecological surgeries. Patients with stable hemoglobin level, were randomized into two groups: Group I (n=181), received no preoperative transfusion but were transfused to compensate for blood loss during surgery. Group II (n=188) received simple or partial exchange transfusion preoperatively. All patients were carefully hydrated and good oxygenation was maintained. The following table illustrates the postoperative complications in both groups: We conclude that avoidance of preoperative transfusion is safe practice in patients with SCA with stable hemoglobin level. On the other hand, the risk associated with transfusion were avoided.