title: Isolated limb perfusion for an irresectable melanoma recurrence in a Jehovah's witness.
abstract: Isolated limb perfusion (ILP) is a treatment option for irresectable melanoma lesions, because with ILP 20-fold higher concentrations of chemotherapy can be achieved locally than is systemically possible and high response rates are subsequently achieved. Jehovah's witnesses do not accept any form of blood transfusion, either autologous or homologous blood or only blood products. The use of an extracorporeal circuit, without the use of any blood products is acceptable for Jehovah's witnesses. The case of a 59-year-old Jehovah's witness with an irresectable melanoma recurrence for which an ILP. Because of adequate blood flow through the perfused limb, the limb did not become acidotic, even though there was a significant drop in the Hb concentration in the limb during the ILP. Isolated limb perfusions without the use of any blood transfusion products are technically possible, but an adequate preoperative hemoglobin concentration is a prerequisite.
authors.affiliation: Erasmus University Medical Center-Daniel den Hoed Cancer Center, Department of Surgical Oncology, Rotterdam, The Netherlands.
authors.forename: Alexander C J
authors.initials: AC
authors.lastname: van Akkooi
authors.forename: Hannah D
authors.initials: HD
authors.lastname: Golab-Schwarz
authors.forename: Alexander M M
authors.initials: AM
authors.lastname: Eggermont
authors.forename: Albertus N
authors.initials: AN
authors.lastname: van Geel
mesh_terms: D001803:Blood Transfusion; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D005260:Female; D006801:Humans; D033221:Jehovah's Witnesses; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery