[Major surgery on Jehovah's Witnesses].
BACKGROUND
Jehovah's Witnesses refuse transfusions of the main blood components. This challenges the safety of performing major surgical procedures. At the Norwegian Radium Hospital, we have taken the views of Jehovah's Witnesses regarding blood transfusions into account when planning major surgical procedures and perform these without such transfusions. We present a case and our experiences and routines when performing major cancer surgery on Jehovah's Witness patients.


METHODS
The medical records of Jehovah's Witnesses, who underwent major surgery at the Norwegian Radium Hospital from April 1992 to February 2006, were surveyed retrospectively. Based on relevant literature, our routines and methods are discussed along with some legal and ethical aspects.


CONCLUSIONS
Major transfusion-free surgery can be performed successfully on Jehovah's Witnesses. This requires advanced planning, good routines and close collaborative team efforts. The most relevant techniques to make major surgery feasible are preoperative optimalisation of the haemoglobin levels and acute normovolemic haemodilution and the use of cell saver under surgery.
Høiseth
Lars Øivind
LØ
Anestesiavdelingen, Rikshospitalet-Radiumhospitalet, 0027 Oslo, Norway. larsoivind.hoiseth@ulleval.no
Giercksky
Karl-Erik
KE
Larsen
Stein Gunnar
SG
Kongsgaard
Ulf
U
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D001803:Blood Transfusion; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D006438:Hemodilution / Q000379:methods; D006801:Humans; D033221:Jehovah's Witnesses; D008297:Male; D009369:Neoplasms / Q000601:surgery*; D010347:Patient Care Planning; D012004:Rectal Neoplasms / Q000601:surgery; D012068:Religion and Medicine; D012189:Retrospective Studies
D004921:Erythropoietin