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Ann Thorac Surg 1998;65:1444-1446
© 1998 The Society of Thoracic Surgeons

Case Reports

Acute Normovolemic Red Cell Exchange for Cardiopulmonary Bypass in Sickle Cell Disease

Gerald Shulman, MDa, Christopher McQuitty, MDb, Roger A. Vertrees, CCPc, Vincent R. Conti, MDc

a Department of Pathology and Laboratory Medicine (Blood Bank Division),, The University of Texas Medical Branch at Galveston, Galveston, Texas USA
b Department of Anesthesiology and Internal Medicine (Cardiology Division), The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
c Department of Surgery (Cardiothoracic Division), The University of Texas Medical Branch at Galveston, Galveston, Texas, USA

Accepted for publication November 18, 1997.

Address reprint requests to Dr Shulman, Blood Bank Division, Department of Pathology, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0717
e-mail: (gshulman{at}utmb.edu)

A patient with sickle cell disease (hematocrit, 28.5%; hemoglobin S fraction, 79%), required mitral valve repair. Partial red cell removal and blood component sequestration with an autotransfusion device before cardiopulmonary bypass initially decreased the sickle red cell mass. This was followed by an acute one-volume whole blood exchange transfusion performed upon the initiation of cardiopulmonary bypass, resulting in a further reduction. Both techniques yielded fresh autologous plasma for use; sequestration yielded a plateletpheresis product. Adequate postbypass hemostasis was demonstrated.




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