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ORIGINAL ARTICLE
Year : 2017  |  Volume : 7  |  Issue : 1  |  Page : 17-21

Preoperative blood transfusion in adults with sickle cell disease undergoing elective surgical procedures: A survey of practice and outcome in Zaria, Nigeria


1 Department of Surgery, Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
2 Department of Orthopedics and Trauma, Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
3 Department of Hematology and Blood Transfusion, Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria

Correspondence Address:
Dr. Dauda M Maigatari
Department of Surgery, Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ais.ais_45_17

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Background: Preoperative blood transfusion, which decreases the proportion of sickle red blood cells and improves anemia, has been associated with decreased risk of perioperative complications. The aim of this study was to retrospectively review our experience in the management of adult patients with sickle cell anemia undergoing elective surgery, and to determine blood transfusion requirement and surgery-related perioperative complications. Patients and Methods: Patients were divided into two groups: Group A had top-up transfusion and Group B received a partial exchange transfusion. Four surgical procedures were analyzed: open cholecystectomy, total hip replacement, total knee replacement, and split thickness skin grafts. Postoperative complications were categorized into three groups – (1) SCD-related, (2) non-SCD-related, and (3) transfusion-related perioperative complications. Results: Twelve (12) patients received top-up transfusion before surgery (Group A) while 20 patients (Group B) received partial exchange transfusions. There were 6 (18%) postoperative complications; two occurred in group A patients who received top-up transfusion and four occurred in group B patients who had partial exchange transfusion. Sickle cell disease-related complications consisted of acute vaso-occlusive pain in two patients (6%). Four patients (12%) had episodes of postoperative fever secondary to atelectasis, urinary tract infection, and wound infection. Only one (3%) patient in group A (top up) had a mild hemolytic transfusion reaction. Conclusion: This study showed that preoperative blood transfusion was associated with a reduced risk of perioperative complications in patients with sickle cell disease who underwent low and medium-risk surgery.


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