AUTOLOGOUS BLOOD-TRANSFUSION AND INTRAOPERATIVE CELL SALVAGE IN A PATIENT WITH HOMOZYGOUS SICKLE-CELL DISEASE

BACKGROUND Autologous transfusion can eliminate the need for homologou s transfusions. In addition, hypotensive anesthesia and devices that s alvage red blood cells for return to the patient can reduce operative blood loss. However, blood from patients with sickle cell disease is d ifficult to store. SUMMARY A 16-year-old black girl with homozygous si ckle cell disease needed surgery for progressive scoliosis. Her family 's religious convictions precluded homologous transfusions. During sur gery, 400 mL of autologous blood that had been successfully stored was transfused, as was 800 mL of blood salvaged using a cell-saving devic e, and 3800 mL of nonblood plasma expanders. Intravenous agents were u sed to maintain hypotension. However, following a rise in the patient' s prothrombin and thromboplastin times, four units of homologous packe d red cells were transfused with the permission of the patient's paren ts. CONCLUSIONS Patients with sickle cell disease can be given hypoten sive anesthesia and autologous transfusions of blood donated before su rgery and blood salvaged during surgery using a cell-saving device.