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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
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Preoperative transfusion versus no transfusion policy in sickle cell disease patients: a randomized trial

Mohamed Elshinawy1,2, Nada Al Marhoobi3, Rashid Al Abri4

  • 1Department of Child Health, Pediatric Hematology/Oncology Unit, Sultan Qaboos University Hospital, Muscat, Oman.

Transfusion
|March 6, 2020
PubMed

Insights

Pediatric patients with sickle cell disease (SCD) undergoing adenotonsillectomy do not require pre-operative transfusions if hemoglobin is above 7.5 g/dL. This approach is safe and does not increase complication risks.

Area of Science:

  • Pediatric Hematology
  • Surgical Complications
  • Transfusion Medicine

Background:

  • Children with sickle cell disease (SCD) often receive pre-operative transfusions before adenotonsillectomy to prevent complications.
  • The necessity and impact of these transfusions on surgical outcomes are not fully understood.

Purpose of the Study:

  • To compare the efficacy of preoperative simple transfusion versus no transfusion in pediatric SCD patients undergoing adenotonsillectomy.
  • To evaluate the incidence of surgical and SCD-related complications in both groups.

Main Methods:

  • Prospective randomized controlled trial involving pediatric patients with SCD.
  • Patients were randomized into two groups: preoperative simple transfusion and no transfusion.
  • Data collected on postoperative complications and hospital stay duration.

Main Results:

  • Overall postoperative SCD-related complications occurred in 4.3% of patients.
  • No significant difference in surgical or SCD-related complications between transfusion and no-transfusion groups (p=0.6 and p=0.8).
  • Homozygous sickle cell anemia patients had a 4.9% complication rate.

Conclusions:

  • Preoperative PRBCs transfusion is not necessary for SCD patients with hemoglobin >7.5 g/dL before adenotonsillectomy.
  • This transfusion strategy does not elevate the risk of postoperative surgical or SCD-related complications.
Abstract

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