Liver histopathologic findings in women with sickle cell disease given prophylactic transfusion during pregnancy

Forty women with a major sickle hemoglobinopathy (hemoglobin SS, SC, or S-β-thalassemia) were given red blood cell transfusions prophylactically during pregnancy. A mean of 13.6 units of erythrocytes per woman was given and none received more than 28 units. Direct-vision needle biopsy of the liver was performed in conjunction with cesarean section or puerperal sterilization. Although iron deposition in hepatocytes and Kupffer cells was identified commonly, neither cirrhosis nor widespread hepatocellular necrosis was found. We conclude that the risk of irreversible hepatic damage is negligible in women with sickle hemoglobinopathies who are given erythrocytes prophylactically during one pregnancy.