on normal subjects is associated with some destruction
of the formed elements of blood. Haemolysis occurs and
plasma haemoglobin levels rise consequently upon the
trauma related to roller pumps and cardiotomy suction.10
Multiple causes of CPB-associated renal damage
have been described (e.g. perioperative haemodynamic
instability and impaired blood flow, an ischaemiareperfusion
injury, generation of reactive oxygen species),
but haemoglobin-induced renal injury is presently
being investigated.11,12 CPB in patients with HS can
exacerbate haemolysis, with the risk of subsequent renal
dysfunction because spherocytes are more susceptible
to mechanical and shear stress.13 There are only a few
available published reports of a surgery with CPB in a
patient with HS. We report a patient who underwent an
aortocoronary bypass procedure on CPB. In view of the
uncertain tolerance to cardiopulmonary bypass of the
abnormal red cells in hereditary spherocytosis, we
reviewed the patient’s chart and analyzed recorded values
of these parameters: free plasma haemoglobin (Hb),
renal parameters, cystatin C (low-molecular weight protein
eliminated by glomerular filtration; its serum level
reflects glomerular filtration rate), bilirubin, liver tests
and urine samples. The patient was informed regarding
our intention to publish his case and also agreed to his
blood sample being sent for free haemoglobin analysis.
Our therapeutic and other diagnostic procedures in this
case were not changed with respect to our standard
guidelines, so local ethics committee approval was not
required.