• Journal of Yeungnam Medical Science
• /
• 제23권1호
• /
• pp.96-102
• /
• 2006

Jehovah's Witnesses refuse a transfusion of blood or blood products because of religious beliefs; this refusal at times presents a dilemma for the treating physician. We report a case of a 25-year-old Jehovah's Witness patient who underwent a reoperation for a previous proximal humerus shaft fracture and experienced unexpected massive hemorrhage intraoperatively and postoperatively. The postoperative lowest hemoglobin level was 2.9 g/dl. The patient recovered from the severe anemia without any clinical sequala. We review the legal, ethical and religious issues and suggest the best possible medical care that Jehovah's Witness patient would permit.

• 대한치과마취과학회지
• /
• 제12권1호
• /
• pp.25-31
• /
• 2012

We report a case of 15 year-old Jehovah's Witness patient with mild anemia who underwent a successful orthognathic two-jaw surgery. Jehovah's Witness patients refuse transfusion of blood or blood products even in life threatening situations. The use of recombinant human erythropoietin and iron supplement increased hemoglobin during preoperative period. Intraoperatively, meticulous surgical hemostasis, acute normovolemic hemodilution and induced hypotension enabled the completion of the operation without the use of blood products.

• Journal of Chest Surgery
• /
• 제25권6호
• /
• pp.645-649
• /
• 1992

Jehovah`s Witnesses who require cardiac operations represent a challenge to surgeon because of the patients` refusal to accept blood transfusion, We report a 6 year period, ending May, 1991 with a consecutive series of 25 Jehovah`s witnesses. Patients ranged in age from 11 months to 61 years. All operations were performed during cardiopulmonary bypass with bloodless priming, No patient received any blood or blood products during hospitalization. Perioperative mortality was 2 paients[8%]. We conclude that if we performed the cardiac surgery with careful operative technique and various blood conserving procedures, we can do the bloodless open heart surgery with relatively safety.

• Clinical and Experimental Pediatrics
• /
• 제59권2호
• /
• pp.100-103
• /
• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.

• Journal of Chest Surgery
• /
• 제30권5호
• /
• pp.537-539
• /
• 1997

40세된 한 여호와의 증인 환자에게 혈액제제의 사용없이 심장이식이 성공적으로 실시되었다. 환자는 수술 전 심방세동을 보여 항응고제를 사용중이었는데 프로트롬빈치가 Hm기준으로 2.4의 상태에서 수술을 시행하였다. 이 환자의 수술후 총 출혈양은 860cc 였으며 최소 헤모글로빈치는 12.2gm/이전로 수술전의 13.8 glen에 비해 불과 1.6 gm/이밖에 감소 하지 않았다. 환자는 수술후 12시간 만에 호흡기를 제거할 수 있었으며 수술후 5개월이 지난 현재까지 경과는 매우 양호한 상태이다. 본 환자에 있어서 성공적인 무혈 수술의 원인은 여러 가지가 있겠지만 이중 cell saver의 사용, 정맥내 aprotinin의 처치, 그리고 수술중 지혈의 세밀함이 중요한 요소라고 본다.

• Journal of Chest Surgery
• /
• 제43권6호
• /
• pp.721-724
• /
• 2010

심혈관계 수술에 있어서도 무혈수술에 대한 관심이 높아져가고 있으나, 현재까지의 무혈 심혈관계 수술은 성인 환자 층에 주로 국한되어 있다. 특히 심폐회로를 이용한 소아의 심혈관계 수술 시에는 혈액희석의 문제로 무혈수술은 기피되어 왔다. 저자들은 최근 여호와의 증인 신자를 부모로 둔 2.8 kg 환아에서 심폐회로를 이용하여 대동맥축착성형술, 심방중격결손 폐쇄술을 무혈수술로 시행한 1예를 경험하여 이에 대해 보고하고자 한다.