Work

Anesthetic and Transfusion Management of an Immunosuppressed Patient With Infective Endocarditis and Severe Platelet Allergy Undergoing Redo Aortic Root Surgery

Year: 2025

Type: article

Abstract: Aortic root replacement for infected endocarditis is associated with excessive bleeding and very high mortality. Bleeding management is mostly achieved with allogenic blood product administration, concomitant pharmacologic agents, and application of hemostatic factors. An immunosuppressed male patient with large B-cell Lymphoma and thrombocytopenia with aortic root abscess underwent root replacement surgery with a homograft. After an allergic reaction to platelet transfusion, a hematologic consult was requested, and guided transfusion was performed perioperatively. In total, six pools of washed platelets and cryoprecipitate were administered. Fresh frozen plasma (FFP) was also used after a test dose. Patients with large B-cell lymphoma typically suffer from bone marrow suppression. An individualized approach is necessary to guide transfusion in this special population. The administration of FFP as a test dose before entering the cardiopulmonary bypass may be useful in managing hemodynamic compromise in case of a reaction. Multidisciplinary management led to a successful outcome.

Source: Cureus

DOI: 10.7759/cureus.83553

Authors: Despoina Sarridou, Rafail Ioannidis, Foteini Iatridi, Giakoumis Mitos, Ekaterini Amaniti

Institutions: Aristotle University of Thessaloniki, AHEPA University Hospital, American Hellenic Educational Progressive Association, Democritus University of Thrace, General Hospital of Drama

Language: English

Topic: Blood transfusion and management

Subfield: Biochemistry

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4410131116