1. Liver transplantation in Jehovah's Witnesses: a case series
- Author
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Fredy Ariza, Sebastian Rosales Hooker-Herrera, Luis Armando Caicedo-Rusca, Eliana Manzi-Tarapues, and Daniel Arboleda-Palacios
- Subjects
medicine.medical_specialty ,Series (stratigraphy) ,Antifibrinolytic ,business.industry ,medicine.drug_class ,medicine.medical_treatment ,Primary Graft Dysfunction ,Perioperative ,Liver transplantation ,Critical Care and Intensive Care Medicine ,medicine.disease ,Intraoperative bleeding ,Surgery ,Liver disease ,Anesthesiology and Pain Medicine ,medicine ,Referral center ,business - Abstract
Introduction: Orthotopic liver transplantation (OLT) is a procedure characterized by high bleeding rates and a significant likelihood of exposure to blood products. Objectives: This case series shows the experience at a referral center for Jehovah's Witnesses (JW) with end-stage liver disease, undergoing OLT. Materials and methods: A search was conducted in our database of JW undergoing OLT between July 2007 and August 2012. The information about their pre-operative condition and progress up to 30 days post-transplantation. Results: Four subjects were identified (3F/1M) with an average age of 42 years (range 22-55). All of them received a multidisciplinary management which included pre-operative optimization of red cell mass, antifibrinolytic prophylaxis, and cell salvage (mean volume of 344mL [range 113-520]). The average intraoperative bleeding volume was of 625mL (range 300-1000). One of the patients presented with a primary graft dysfunction and died, while the rest had a normal postoperative course. Conclusion: It is possible to offer OLT to patients who refuse to receive allogeneic blood transfusions, through a comprehensive approach that includes perioperative hematologic optimization and the use of blood conservation measures, without a significant impact on the outcomes.
- Published
- 1969