{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T23:49:18Z","timestamp":1782258558400,"version":"3.54.5"},"reference-count":36,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Individuals with sickle cell disease (SCD) are likely to be referred for surgery at some point in their lifetime due to a high incidence of musculoskeletal and intrabdominal complications such as avascular necrosis and gallbladder disease. Preoperative optimization is a multidisciplinary process that involves a hematologist with SCD expertise, an anesthesiologist, and the surgical team. The type and risk classification of the surgery, disease severity, medications, baseline hemoglobin, transfusion history, and history of prior surgical complications are often documented. Clinicians should consider perioperative risk assessment that includes determining the patient's functional status and cardiovascular risk and screening for obstructive sleep apnea. Many patients will require preoperative transfusion to reduce the risk of postoperative complications such as acute chest syndrome and vaso-occlusive pain crises. The hematologist should consider the patient's preoperative transfusion requirements and ensure that the surgical team has an appropriate plan for postoperative observation and management. This often includes follow-up laboratory studies, a postoperative pain management plan, and venous thromboembolism prophylaxis. The transfusion plan should be patient-specific and take into account the SCD genotype, baseline hemoglobin, disease severity, risk classification of the surgery, and history of prior surgical complications. In the intraoperative and postoperative period, dehydration, hypothermia, hypotension, hypoxia, and acidosis should be avoided, and incentive spirometry should be utilized to minimize complications such as acute chest syndrome. In this review we discuss preoperative, intraoperative, and postoperative strategies to optimize patients with SCD undergoing surgery.<\/jats:p>","DOI":"10.1182\/hematology.2021000274","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T12:14:32Z","timestamp":1639138472000},"page":"405-410","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":16,"title":["Optimizing management of sickle cell disease in patients undergoing surgery"],"prefix":"10.1182","volume":"2021","author":[{"given":"Charity I.","family":"Oyedeji","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian J.","family":"Welsby","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, NC"},{"name":"Department of Anesthesiology, Duke University Medical Center, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"issue":"6","key":"2021121012073920700_hem2021000274C1","doi-asserted-by":"crossref","first-page":"480","DOI":"10.2471\/BLT.06.036673","article-title":"Global epidemiology of haemoglobin disorders and derived service indicators","volume":"86","author":"Modell","year":"2008","journal-title":"Bull World Health Organ"},{"key":"2021121012073920700_hem2021000274C2","doi-asserted-by":"crossref","first-page":"18010","DOI":"10.1038\/nrdp.2018.10","article-title":"Sickle cell disease","volume":"4","author":"Kato","year":"2018","journal-title":"Nat Rev Dis Primers"},{"issue":"5","key":"2021121012073920700_hem2021000274C3","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/j.hoc.2005.07.004","article-title":"Surgery in sickle cell disease","volume":"19","author":"Buck","year":"2005","journal-title":"Hematol Oncol Clin North Am"},{"issue":"10","key":"2021121012073920700_hem2021000274C4","doi-asserted-by":"crossref","first-page":"3676","DOI":"10.1182\/blood.V86.10.3676.bloodjournal86103676","article-title":"Surgery and anesthesia in sickle cell disease. 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