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Online ISSN 1827-1596
Pérez Ferrer A. 1, Ferrazza V. 2, Gredilla E. 1, de Vicente J. 1, de la Rua A. 3 , Larrea A. 4
1 Anaesthesia and Resuscitaiton Unit, La Paz University Children’s Hospital, Madrid, Spain;
2 Anaesthesiology and Resuscitation Unit, Umberto I University Polyclinic, Rome, Italy;
3 Haematology Unit, La Paz University Hospital, Madrid, Spain;
4 Anaesthesia and Resuscitation Unit, Donostia University Hospital, San Sebastian, Spain
A patient with thalassemia minor and idiopathic scoliosis was scheduled for posterior vertebral arthrodesis. The diagnosis of thalassemia minor was made during the preoperative assessment. Preoperative blood cell count displayed the following data: red blood count 5.4×106/µL, haemoglobin 11.6 g/dL and hematocrit 36.9%. As corrective surgery for scoliosis is associated with major blood loss, the patient was scheduled for preoperative treatment with human recombinant erythropoietin (rHuEPO), autologous blood donation, intraoperative blood cell salvage and administration of tranexamic acid. The use of rHuEPO was intended to increase hemoglobin (12.1 g/dL) levels at the moment of surgery following the donation of 2 autologous blood units. 1000 mL of salvaged blood were processed. The output line of the blood cell salvage machine did not show any sign of increased red cell haemolysis. The postoperative course was uneventful and the patient was discharged from the postoperative intensive care unit on day 7 after surgery with no allogenic blood transfusion. No references detailing the use of rHuEPO and autologous blood donation preoperatively in patients with thalassemia minor and only one case report discussed the utility of intraoperative blood cell salvage in a patient with thalassemia intermedia. Although further experience is needed, this case report suggests that even for patients with thalassemia minor, methods focused on allogenic blood salvage can be used safely.