Management of Intraoperative Sickle Crisis During Kidney Transplant in a Patient With Sickle Cell Disease: A Case Report.

A 31-year-old male patient with a history of sickle cell disease (SCD) with stage V chronic kidney disease (CKD) presented for a deceased donor kidney transplant. During surgery, the transplanted kidney showed mottling and limited cortical flow, raising concerns for an intraoperative sickle cell crisis versus hyperacute rejection. Postoperative imaging revealed decreased vascularity, and the patient was treated with RBC exchange. Pathology confirmed thrombotic microangiopathy without acute rejection. The patient's condition improved with supportive care, and he was discharged by postoperative day 10. This case highlights the complexity of managing SCD patients undergoing organ transplantation, with a focus on intraoperative challenges and postoperative care.