Preoperative management of sickle cell patients.

During a 12-year period, 59 patients with sickle cell disease underwent a total of 73 operative procedures. There was a total of 30 non-sickle-cell-related and 7 sickle-cell-related complications for an incidence of 41% and 10% respectively. There were no deaths. When complications were compared between patients that were transfused and those not transfused, there was no difference in the incidence of sickle-cell-related complications with an 8% incidence for the non-transfused group and 10% for the transfused group. A higher incidence of non-sickle-cell-related complications (46% versus 32%) was noted in the transfused group, with atelectasis being the most common complication (p = .29). The type of transfusion therapy did not influence morbidity, since the complication rates in the simple and exchange transfusion groups were similar. In conclusion, our data indicate that routine preoperative blood transfusion does not appear to be beneficial in the surgical sickle cell patient, since preoperative blood transfusions did not reduce the incidence of sickle-cell-related complications.