Korean J Crit Care Med.  2016 May;31(2):101-110. 10.4266/kjccm.2016.31.2.101.

Blood Conservation Strategy during Cardiac Valve Surgery in Jehovah's Witnesses: a Comparative Study with Non-Jehovah's Witnesses

• Kim TS
• Lee JH
• Na CY

• KMID: 2350916
• DOI: http://doi.org/10.4266/kjccm.2016.31.2.101

Abstract

BACKGROUND
We compared the clinical outcomes of cardiac valve surgery in adult Jehovah's Witness patients refusing blood transfusion to those in non-Jehovah's Witness patients without any transfusion limitations.
METHODS
From 2005 to 2014, 25 Jehovah's Witnesses (JW group) underwent cardiac valve surgery using a blood conservation strategy. Twenty-five matched control patients (non-JW group) were selected according to sex, age, operation date, and surgeon. Both groups were managed according to general guidelines of anticoagulation for valve surgery.
RESULTS
The operative mortality rate was 4.0% in the JW group and 0% in the non-JW group (p = 1.000). There was no difference in postoperative major complications between the groups (p = 1.000). The overall survival rate at 5 and 10 years was 85.6% ± 7.9% and 85.6% ± 7.9% in the JW group, respectively, and 100.0% ± 0.0% and 66.7% ± 27.2% in the non-JW group (p = 0.313). The valve-related morbidity-free survival rates (p = 0.625) and late morbidity-free survival rates (p = 0.885) were not significantly different between the groups.
CONCLUSIONS
Using a perioperative strategy for blood conservation, cardiac valve surgery without transfusion had comparable clinical outcomes in adult patients. This blood conservation strategy could be broadly applied to major surgeries with careful perioperative care.

Keyword

blood; heart valves; Jehovah's witness; open heart surgery; perioperative care; transfusion

MeSH Terms

Adult
Blood Transfusion
Bloodless Medical and Surgical Procedures*
Heart Valves*
Humans
Jehovah's Witnesses*
Mortality
Perioperative Care
Survival Rate

Figure

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  Fig. 1. Actuarial overall survival in the JW and non-JW groups (log-rank, p = 0.313). JW: Jehovah’s Witness.

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  Fig. 2. Actuarial valve-related morbidity-free survival in the JW and non-JW groups (log-rank, p = 0.625). JW: Jehovah’s Witness.

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  Fig. 3. Actuarial late morbidity-free survival in the JW and non-JW groups (log-rank, p = 0.885). JW: Jehovah’s Witness.

Reference

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