title: Liver transplantation in Jehovah's witnesses.
abstract: For religious reasons, Jehovah's witnesses refuse transfusion of blood products (red cells, platelets, plasma), but may accept organ transplantation. The authors developed a multidisciplinary protocol for liver transplantation in Jehovah's witnesses. In a 6-year period, nine Jehovah's witness patients were listed for liver transplantation. They received preoperative erythropoietin therapy, with iron and folic acid that allowed significant haematocrit increase. Two patients underwent partial spleen embolization to increase platelet count. Seven patients underwent cadaveric whole liver transplantation, and two right lobe living-related liver transplantation, using continuous circuit cell saving system and high dose aprotinin. No patient received any blood product during the surgical procedure. One patient suffering from deep anaemia after living-related liver transplantation was transfused as required by his family, but died from aspergillus infection. One 6-year-old child was transfused against her parent's will. The authors demonstrated that it is possible to increase haematocrit and platelet levels in cirrhotic patients awaiting liver transplantation. They were able to reduce intraoperative need for blood products, allowing liver transplantation in prepared Jehovah's witness patients. This experience may be beneficial for non-Jehovah's witness liver transplant recipients.
authors: Department of Abdominal Surgery and Transplantation, University of Liège, Liège, Belgium. oli.detry@chu.ulg.ac.be
authors: Olivier
authors: O
authors: Detry
authors: Arnaud De
authors: AD
authors: Roover
authors: Jean
authors: J
authors: Delwaide
authors: Abdour
authors: A
authors: Kaba
authors: Jean
authors: J
authors: Joris
authors: Pierre
authors: P
authors: Damas
authors: Maurice
authors: M
authors: Lamy
authors: Pierre
authors: P
authors: Honoré
authors: Michel
authors: M
authors: Meurisse
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033221:Jehovah's Witnesses; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged