ERYTHROPOIETIN AND DESMOPRESSIN OBVIATED TRANSFUSION IN A THROMBOASTHENIC JEHOVAH-WITNESS UNDERGOING SCOLIOSIS SURGERY

A 13-year-old female Jehovah's Witness with thromboasthenia was schedu led for scoliosis surgery. To reduce the risk of heterologous transfus ion, she was given erythropoietin for 2 weeks preoperatively. Bleeding time and platelet dysfunction normalized during erythropoietin treatm ent, but the hemoglobin concentration increased only marginally. Desmo pressin and tranexamic acid were given as cover for surgery. Blood los s was less than that in the average scoliosis patient, 1,490 ml as com pared to 2,740 ml, and no heterologous transfusion was given. Erythrop oietin may thus be given preoperatively, not only to increase the hemo globin concentration, but also to improve the platelet function in thr omboasthenic patients.