Blood transfusions for people with sickle cell disease before they undergo surgery Updated

Once they have given up their oxygen, red blood cells in people with sickle cell disease become shaped like crescents. These cells can block blood vessels, which causes problems throughout the body. People with sickle cell disease often need surgery, but this can increase the number of sickle-shaped cells in the blood. Blood transfusions before an operation can help dilute the sickled red blood cells and increase the level of oxygen in the blood. This reduces the risk of blood vessels becoming blocked causing further damage. Blood transfusions can be full or partial. They can be linked to adverse events such as the development of antibodies to foreign red blood cells, iron overload, infection rates after surgery and length of stay in hospital. Two studies with 920 people are included in the review. One study compared full transfusion to partial transfusion. This showed no difference between the two treatments in preventing complications immediately after surgery, but partial transfusion was linked to fewer adverse events. The second study compared transfusion to standard care and did not show an advantage in transfusion. Both studies reported a range of complications related to transfusion. However, many details of study design were not recorded in the published papers and statistical analysis indicated a lack of certainty in the findings. There is not enough evidence to recommend blood transfusions before surgery for people with sickle cell disease as standard practice. A large study should look at the best use of this treatment and consider different risk groups.