Successful transfusion-free pancreatectomy in Jehovah's Witness patients.
OBJECTIVE
Although perioperative therapies have improved greatly, pancreatectomies still often need blood transfusions. However, the morbidity from blood transfusions, the poor prognosis of blood transfused patients, high cost, and decreasing supply of blood products is accelerating transfusion-free (TF) surgery in the patients who have pacreatectomies. The aim of this study was to assess the feasibility of TF pancreatectomies for patients who are Jehovah's Witness.


METHODS
We investigated the possibility of TF pancreatectomies for the Jehovah's Witness patients undergoing pancreatectomies between January 2007 and Februay 2014. There were 4 cases of Whipple's operation, 4 of pylorus-preserving pancreaticoduodenectomy, 2 of radical antegrade modular pancreatosplenectomy and 1 of laparoscopic distal pancreatectomy. All were performed by one surgeon.


RESULTS
Most of the TF pancreatecomies patients received perioperative blood augmentation and intraoperative acute normovolemic hemodilution (ANH). They received no blood transfusions at any time during their hospitalization, and pre- and intra-operative data and outcomes were acceptably favorable.


CONCLUSIONS
To the best of our knowledge, this report is the first successful consecutive pancreatectomy program for Jehovah's Witness not involving blood transfusion. TF pancreatectomy can be performed successfully in selected Jehovah's Witness. Postoperative prognosis and outcomes should be confirmed in follow up studies.
Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
Jong Oh
JO
Lee
Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
Dong Won
DW
Kim
Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
Mi Ae
MA
Jeong
Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
Hee Jong
HJ
Lee
Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
Kyu Nam
KN
Kim
Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
Dongho
D
Choi
Jehovah's Witness; Pancreatectomy; Transfusion-free surgery