Bloodless Surgery in a Jehovah’s Witness Patient with a 12.7-kg Uterine Leiomyosarcoma

Nagarsheth, Nimesh P.; Shander, Aryeh; Malovany, Robert; Tzeng, Jausheng; Ibrahim, Ibrahim

doi:10.1016/j.jsurg.2007.03.008

Cited by 13 publications

(17 citation statements)

References 15 publications

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“…Preoperative anemia is actively screened and, if present, treated before surgery. Protocols for postoperative bleeding include immediate identification and treatment of the source of bleeding with return to the operating room if necessary . We presume that these concerted efforts may have played a significant role in our patients having a relatively higher nadir Hb levels compared with the cohort of Carson and colleagues .…”

Section: Discussionmentioning

confidence: 91%

An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME)

et al. 2014

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Section: Discussionmentioning

confidence: 91%

An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME)

et al. 2014

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“…The medical knowledge gained in the care of Jehovah Witnesses has turned the concept of restriction of blood transfusions into reality and redirected transfusion medicine towards a more blood conservation oriented management [1]. Bloodless surgery schemes are part of a multidisciplinary approach to patient care that involves all the measures and clinical strategies that are taken in order to prevent or at least minimise blood loss without allogenic transfusion [2,3]. Current and emerging advances have offered a new approach to the surgical management of patients that refuse an allogenic blood transfusion.…”

Section: Reviewmentioning

confidence: 99%

“…An independent review of the literature revealed seventeen clinical studies that have examined the effect of blood conservation management schemes in patients undergoing surgery for gynecologic malignancy or major pelvic surgery in general [3,17-31] (Table 1). …”

Section: Reviewmentioning

confidence: 99%

“…Finally, in the hands of well-trained interventional radiologists, uterine artery embolisation has been reported in the literature as an effective preoperative technique that minimises intraoperative blood loss [3,20]. Potential risks include fertility compromise, the classic post-embolisation syndrome (infection, peritoneal and intrauterine adhesions) and irradiation hazard [40].…”

Section: Reviewmentioning

confidence: 99%

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Non-blood medical care in gynecologic oncology: a review and update of blood conservation management schemes

et al. 2011

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This review attempts to outline the alternative measures and interventions used in bloodless surgery in the field of gynecologic oncology and demonstrate their effectiveness. Nowadays, as increasingly more patients are expressing their fears concerning the potential risks accompanying allogenic transfusion of blood products, putting the theory of bloodless surgery into practice seems to gaining greater acceptance. An increasing number of institutions appear to be successfully adopting approaches that minimize blood usage for all patients treated for gynecologic malignancies. Preoperative, intraoperative and postoperative measures are required, such as optimization of red blood cell mass, adequate preoperative plan and invasive hemostatic procedures, assisting anesthetic techniques, individualization of anemia tolerance, autologous blood donation, normovolemic hemodilution, intraoperative cell salvage and pharmacologic agents for controlling blood loss. An individualised management plan of experienced personnel adopting a multidisciplinary team approach should be available to establish non-blood management strategies, and not only on demand of the patient, in the field of gynecologic oncology with the use of drugs, devices and surgical-medical techniques.

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“…Dennoch können auch Zeugen Jehovas von modernen Therapien einschließlich großer operativer Eingriffe [14,40,41,42,67,72,84] profitieren, ohne dass ein übertrieben hohes Letalitätsrisiko in Kauf genommen werden muss. Voraussetzung ist ein perioperatives Management, das -in der jeweils gebotenen Abstufung -die zur Verfügung stehenden und von Zeugen Jehovas akzeptierten Maßnahmen zur Vermeidung von Fremdbluttransfusionen beinhaltet.…”

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Perioperatives Management bei Zeugen Jehovas

Häbler

Voß

2010

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The religious organization of Jehovah's Witnesses numbers more than 7 million members worldwide, including 165,000 members in Germany. Although Jehovah's Witnesses strictly refuse the transfusion of allogeneic red blood cells, platelets and plasma, Jehovah's Witness patients may nevertheless benefit from modern therapeutic concepts including major surgical procedures without facing an excessive risk of death. The present review describes the perioperative management of surgical Jehovah's Witness patients aiming to prevent fatal anemia and coagulopathy. The cornerstones of this concept are 1) education of the patient about blood conservation techniques generally accepted by Jehovah's Witnesses, 2) preoperative optimization of the cardiopulmonary status and correction of preoperative anemia and coagulopathy, 3) perioperative collection of autologous blood, 4) minimization of perioperative blood loss and 5) utilization of the organism's natural anemia tolerance and its acute accentuation in the case of life-threatening anemia.

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Bloodless Surgery in a Jehovah’s Witness Patient with a 12.7-kg Uterine Leiomyosarcoma

Cited by 13 publications

References 15 publications

An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME)

An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME)

Non-blood medical care in gynecologic oncology: a review and update of blood conservation management schemes

Perioperatives Management bei Zeugen Jehovas

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