Abstract
We report herein the case of a 61-year-old man with myelodysplastic syndrome causing pancytopenia who underwent successful coronary artery bypass grafting (CABG). Preoperatively, his hemoglobin (Hb) value was 10.4 g/dl while receiving transfusions of 1 or 2 units of red blood cells (RBC) every 2 weeks, his white blood cell (WBC) count was 8200/μl with injections of 100 μg granulocyte colony-stimulating factor (G-SCF) every 5 days, and his platelet count was 4.5×104/μl without platelet transfusion. From the time the pancytopenia was diagnosed in his peripheral blood, he had received a total of 104 units of RBC and 472 units of platelets, following which he developed an antiplatelet antibody, not for a platelet-specific antigen, but for an HLA antigen. Thus, HLA-matched platelets were prepared to prevent bleeding caused by thrombocytopenia, and the WBC count was elevated preoperatively by G-CSF injections. Thereafter, CABG was performed on three vessels. The HLA-matched platelets were transfused as the patient was weaned from the extracorporeal circulation. As a result of these preparations, we were able to protect the patient against bleeding and infection.
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Yamagishi, T., Fuse, K., Saito, T. et al. Successful coronary artery bypass grafting for a patient with myelodysplastic syndrome: Report of a case. Surg Today 26, 740–743 (1996). https://doi.org/10.1007/BF00312098
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DOI: https://doi.org/10.1007/BF00312098