title: Blood management strategies for total hip arthroplasty in Jehovah's witness patients.
abstract: Total hip arthroplasty is associated with extensive blood loss, which is often corrected using allogeneic blood transfusions. However, Jehovah's Witnesses often refuse allogeneic blood transfusions or certain types of autologous blood transfusions due to their religious beliefs. This may represent a tremendous challenge for the orthopaedic surgeon and their team. Performing a total hip arthroplasty on a Jehovah's Witness patient requires a well-trained group of physicians willing to pre-operatively optimize the patient, attempt to minimize the blood loss during the surgery, adequately manage the post-operative period, and be aware of which of the life-saving strategies can be used in these patients during an emergency situation. Ultimately, physicians should be prepared to deal with marked blood loss and respect the patients' wishes, values, and beliefs. This review focuses on studies where primary or revision total hip arthroplasty was performed in Jehovah's Witness patients. Therefore, we will illustrate that with a prepared team and an optimized patient, it is potentially quite safe to perform total hip arthroplasties in Jehovah's Witness patients.
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement Sinai Hospital of Baltimore Baltimore, MD.
authors.forename: Julio J
authors.initials: JJ
authors.lastname: Jauregui
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement Sinai Hospital of Baltimore Baltimore, MD.
authors.forename: Bhaveen H
authors.initials: BH
authors.lastname: Kapadia
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement Sinai Hospital of Baltimore Baltimore, MD.
authors.forename: Samik
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: Seton Hall University School of Health and Medical Sciences Department of Orthopaedic Surgery South Orange Village, New Jersey.
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.affiliation: Seton Hall University of Health and Medical Sciences Paterson, NJ.
authors.forename: Sherwin
authors.initials: S
authors.lastname: Su
authors.affiliation: Beth Israel Medical Center Adult Reconstruction and Total Joint Replacement Service New York, NY.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Harwin
authors.affiliation: Sinai Hospital of Baltimore Baltimore, MD.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D057668:Bloodless Medical and Surgical Procedures; D000075202:Contraindications; D005260:Female; D006801:Humans; D033221:Jehovah's Witnesses; D008297:Male; D008875:Middle Aged; D055815:Young Adult