Major thoracic surgery in Jehovah's witness: A multidisciplinary approach case report

Rispoli, Marco; Bergaminelli, Carlo; Nespoli, M; Esposito, Mariangela; Mattiacci, Dario Maria; Corcione, Antonio; Buono, Salvatore

doi:10.1016/j.ijscr.2016.04.024

Cited by 7 publications

(10 citation statements)

References 29 publications

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“…Some reports have described surgical treatment for JWs [ 1 , 2 , 7 – 9 ]. Although case reports have described abdominal surgery, cardiovascular surgery, and liver or lung transplantation, very few have mentioned pulmonary surgery, especially cases of lung cancer [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Our experience of lung resection in patients who decline blood transfusion for religious reasons

Takagi

Muto

Yamaguchi

et al. 2021

Gen Thorac Cardiovasc Surg

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Objective Surgical treatment for patients who refuse blood transfusion due to religious beliefs is an important issue related to medical safety. Few reports have examined pulmonary surgery for these patients, and we analyzed clinical characteristics in such cases. Methods Ten Jehovah’s Witness (JW) patients with lung tumor resection who declined blood transfusion for religious reasons between December 2013 and February 2020 at the Fukushima Medical University Hospital were included. Median total intraoperative blood loss was 17.5 mL (range 5–150 mL). Fibrin glue was used intraoperatively for 8 patients. Final pathological examination revealed pulmonary adenocarcinoma in 9 cases and metastasis of bladder cancer in 1 case. In 8 patients with pulmonary adenocarcinoma examined for epidermal growth factor receptor (EGFR) gene mutation, 6 cases showed mutation. No patients had serious complications, but 1 patient displayed temporary anemia due to postoperative hemorrhagic gastrointestinal ulcer. Result and conclusions Our findings confirm that pulmonary resection is feasible and safe for JW patients if performed by experienced medical staff. However, awareness of complications associated with perioperative bleeding is important. Each JW patient should be interviewed individually and every available perioperative option aimed at blood-sparing management, including use of blood coagulation factors and fibrinogen concentrates, should be carefully discussed and clarified. In this study, the EGFR gene mutation rate was higher than usual for cases of lung adenocarcinoma. Further studies are necessary to assess clinical features in JW patients with lung cancer.

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Section: Discussionmentioning

confidence: 99%

Our experience of lung resection in patients who decline blood transfusion for religious reasons

Takagi

Muto

Yamaguchi

et al. 2021

Gen Thorac Cardiovasc Surg

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Section: Alternatives To Blood Transfusionmentioning

confidence: 99%

“…5,10,11,23 Furthermore, the utilisation of a multidisciplinary team (MDT) approach is highlighted frequently within the literature as being central to the establishment of a bloodless protocol for Witness patients. [34][35][36] This is especially important given The utilisation of minimal approaches has been advocated in cardiac surgery in recent years. One key example of this is the utilisation of transcatheter device closure as opposed to surgical closure of atrial and ventricular septal defects Majority of these considerations will be applicable as they do not utilise blood products specifically Potential therapeutic options available and currently advocated as alternatives to blood transfusions as per current guidelines and recommendations.…”

Section: Alternatives To Blood Transfusionmentioning

confidence: 99%

Outcomes of cardiac surgery in Jehovah’s Witness patients: A review

et al. 2020

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Objective: To review current literature evidence on outcomes of cardiac surgery in Jehovah’s Witness patients. Methods: A comprehensive electronic literature search was done from 2010 to 20th August 2020 identifying articles that discussed optimisation/outcomes of cardiac surgery in Jehovah’s Witness either as a solo cohort or as comparative to non-Jehovah’s Witnesses. No limit was placed on place of publication and the evidence has been summarised in a narrative manner within the manuscript. Results: The outcomes of cardiac surgery in Jehovah’s Witness patients has been described, and also compared, to non-Witness patients within a number of case reports, case series and comparative cohort studies. Many of these studies note no significant differences between outcomes of the two groups for a number of variables, including mortality. Pre-, intra and post-operative optimisation of the patients by a multidisciplinary team is important to achieve good outcomes. Conclusion: The use of a bloodless protocol for Jehovah’s Witnesses does not appear to significantly impact upon clinical outcomes when compared to non-Witness patients, and it has even been suggested that a bloodless approach could provide advantages to all patients undergoing cardiac surgery. Larger cohorts and research across multiple centres into the long term outcomes of these patients is required.

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“…5,10,11,23 Furthermore, the utilisation of a multidisciplinary team (MDT) approach is highlighted frequently within the literature as being central to the establishment of a bloodless protocol for Witness patients. [34][35][36] This is especially important given that blood transfusions themselves have associated risks and consequences, and that in some circumstances a bloodless regime may in fact be a good treatment approach. 10,37 Blood transfusions and associated risks Blood transfusions are not without risk, for example acute transfusion reactions, ranging from mild to lifethreatening, such as mild urticaria, acute haemolytic reactions, transfusion-associated circulatory overload and transfusion-related acute lung injury.…”

Section: Alternatives To Blood Transfusionmentioning

confidence: 99%

Outcomes of Cardiac Surgery in Jehovah’s Witness Patients: A Review

Chambault

Brown

Mellor

et al. 2020

Preprint

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Objective: To review current literature evidence on outcomes of cardiac surgery in Jehovah's Witness patients. Methods: A comprehensive electronic literature search was done from 2010 to 20th August 2020 identifying articles that discussed optimisation/outcomes of cardiac surgery in Jehovah's Witness either as a solo cohort or as comparative to non-Jehovah's Witnesses. No limit was placed on place of publication and the evidence has been summarised in a narrative manner within the manuscript. Results: The outcomes of cardiac surgery in Jehovah's Witness patients has been described, and also compared, to non-Witness patients within a number of case reports, case series and comparative cohort studies. Many of these studies note no significant differences between outcomes of the two groups for a number of variables, including mortality. Pre-, intra and post-operative optimisation of the patients by a multidisciplinary team is important to achieve good outcomes. Conclusion:The use of a bloodless protocol for Jehovah's Witnesses does not appear to significantly impact upon clinical outcomes when compared to non-Witness patients, and it has even been suggested that a bloodless approach could provide advantages to all patients undergoing cardiac surgery. Larger cohorts and research across multiple centres into the long term outcomes of these patients is required.

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Major thoracic surgery in Jehovah's witness: A multidisciplinary approach case report

Abstract: HighlightsBloodless surgery multidisciplinary approach.Management of Jehovah's witness patient.Patient-centered blood products use.

Cited by 7 publications

References 29 publications

Our experience of lung resection in patients who decline blood transfusion for religious reasons

Our experience of lung resection in patients who decline blood transfusion for religious reasons

Outcomes of cardiac surgery in Jehovah’s Witness patients: A review

Outcomes of Cardiac Surgery in Jehovah’s Witness Patients: A Review

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