Anesth Pain Med.  2006 Jul;1(1):68-72.

Anesthetic Management for Abdominal Aortic Aneurysm Surgey without Homologous Blood Transfusion in Adult Jehovah'sWitness : A case report

• Jeong JY
• Hur WS
• Lee JR
• Jung CW
• Lee KH

Abstract

Jehovah's Witnesses present a challenge for the anesthesia professionals on account of their refusal to accept blood and blood products. Therefore, anesthesiologists must be able to individualize their treatment depending on the patients' condition. We report a case of a stent removal and aorto-biiliac bypass surgery in a Jehovah's Witness. A 69 year-old, hypertensive man presented with claudication of both lower extremities due to the distal migration of an endoaneurysmal stent. According to his previous medical history, he had a lacunar infarction in the right middle cerebral artery territory, ischemic coronary artery disease with a stent in situ, and a stent inserted for an abdominal aortic aneurysm by radiological intervention. Because he strongly refused a transfusion, human recombinant erythropoietin was used before surgery. After the erythropoietin treatment, hemoglobin level increased to 14.8 g/dl (hematocrit 47.6%). During the operation, closed-circuit cell saver was used and transfused autologous blood was saved by acute normovolemic hemodilution. The patient recovered uneventfully from the anesthesia and was transferred to the intensive care unit. He was discharged on the ninth postoperative day without complications with a hematocrit level of 28.9%.

Keyword

acute normovolemic hemodilution; aortic aneurysm; cell saver; erythropoietin; Jehovah's Witness

MeSH Terms

Adult*
Aged
Anesthesia
Aortic Aneurysm
Aortic Aneurysm, Abdominal*
Blood Transfusion*
Coronary Artery Disease
Disulfiram
Erythropoietin
Hematocrit
Hemodilution
Humans
Intensive Care Units
Jehovah's Witnesses
Lower Extremity
Middle Cerebral Artery
Stents
Stroke, Lacunar
Disulfiram
Erythropoietin