Abstract
Background
Protein S deficiency is associated with increased risk of venous thromboembolism,
complicating the perioperative management of such patients. We present a patient with
sickle cell disease (Hb SC genotype) and inherited protein S deficiency who underwent
a living-donor renal transplant. To minimize thrombotic risk and sickle cell complications,
both plasma exchange and red blood cell (RBC) exchange transfusion were performed
pre-operatively.
Methods and materials
Plasma exchange was utilized to increase protein S levels and to reduce the risk of
post-operative venous thromboembolism, including allograft thrombosis, while RBC exchange
was performed to reduce the risk of acute post-operative sickle cell disease complications.
Results
With the use of combined pre-operative plasma exchange and RBC exchange transfusion,
this patient with protein S deficiency and Hb SC underwent a successful renal transplant
without acute sickle cell complications or thrombotic complications.
Conclusions
This case demonstrates the potential use of pre-operative plasma exchange in patients
with protein S deficiency undergoing high thrombotic risk procedures.
Keywords
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Article info
Publication history
Published online: December 15, 2021
Accepted:
December 13,
2021
Received in revised form:
November 30,
2021
Received:
August 18,
2021
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
