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 x 106/microL, 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.