Cardiopulmonary bypass in sickle cell anaemia without exchange transfusion

To minimize sickling during cardiopulmonary bypass, exchange transfusion is frequently recommended peri-operatively for patients with homozygous sickle cell anaemia to reduce the circulating concentration of HbS. We report the successful management of two children both aged 12 years with sickle cell anaemia (homozygous SS), several sickle cell crises and multiple blood transfusions who underwent cardiopulmonary bypass for mitral valve replacement. No pre- or intra-operative exchange transfusions were employed in the two cases. Furthermore, moderate hypothermia in both cases was not associated with adverse sequelae.