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USE OF THROMBOELASTOGRAPHY TO GUIDE PLATELET INFUSION IN A PATIENT WITH WISKOTT-ALDRICH SYNDROME UNDERGOING RENAL TRANSPLANT

AMMAR AL MİDANİ, CİARA DONOHUE, PETER BERRY, GARETH JONES, BİMBİ FERNANDO

Experimental and Clinical Transplantation - 2020;18(5):636-637

Renal Transplant Unit, Royal Free Hospital, NHS Foundation Trust, and the Anaesthetist Unit, Royal Free Hospital, NHS Trust Foundation, London, United Kingdom

 

Wiskott-Aldrich syndrome is a rare primary immuno - deficiency disorder that is characterized by a triad of microthrombocytopenia, eczema, and recurrent infections. Progression to end-stage renal failure is common in survivors due to immunoglobulin A nephropathy. We describe the case of a 24-year-old male with Wiskott-Aldrich syndrome. The patient had previous hematopoietic stem cell transplant and was on hemodialysis due to end-stage renal failure. He subsequently underwent living-donor renal transplant from his mother as the donor. This is only the fifth case of renal transplant in a patient with Wiskott-Aldrich syndrome in the world. In all cases, the perioperative management of hemostatic function has been crucial. We used thromboelastography to guide our hemostatic decisions rather than platelet count, thus reducing exposure to unnecessary platelet transfusions and without increased bleeding risk. Our patient had an uneventful course after living-donor kidney transplant.