title: Coagulopathy after cardiopulmonary bypass in Jehovah's Witness patients: management of two cases using fractionated components and factor VIIa.
abstract: BACKGROUND
  Changes in the Jehovah's Witness (JW) blood refusal policy now give members the personal choice to accept certain processed fractions of blood, such as factor concentrates and cryoprecipitate.
  
  
  METHODS
  Two JW patients undergoing complex aortic surgery who developed severe microvascular bleeding after prolonged use of cardiopulmonary bypass were treated with recombinant activated factor VII, cryoprecipitate, and antithrombin concentrate.
  
  
  RESULTS
  Cardiopulmonary bypass-induced coagulopathy was successfully treated, allowing chest closure without evidence of thrombotic complications.
  
  
  CONCLUSIONS
  Processed blood fractions can be a valuable adjuvant to drugs when treating bleeding in JW patients.
authors: Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA. roman.sniecinski@emoryhealthcare.org
authors: Roman M
authors: RM
authors: Sniecinski
authors: Edward P
authors: EP
authors: Chen
authors: Jerrold H
authors: JH
authors: Levy
authors: Fania
authors: F
authors: Szlam
authors: Kenichi A
authors: KA
authors: Tanaka
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D000991:Antithrombins / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000601:surgery; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002315:Cardiopulmonary Bypass; D003029:Coagulants / Q000627:therapeutic use*; D005169:Factor VIII / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use*; D005340:Fibrinogen / Q000627:therapeutic use; D006801:Humans; D007258:Informed Consent; D033221:Jehovah's Witnesses; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D011994:Recombinant Proteins / Q000627:therapeutic use; D012068:Religion and Medicine; D014481:United States
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D003029:Coagulants; D011994:Recombinant Proteins; C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen; D015942:Factor VIIa