Thoraco-abdominal aneurysm repair usually necessitates blood or blood product transfusion which is prohibited in Jehovah's Witnesses. We report the blood conservation strategy used during thoraco-abdominal aneurysm repair in a Jehovah's Witness. This included pre-operative recombinant erythropoietin, per-operative acute normovolaemic haemodilution, cell salvage, aprotinin, restricted heparinisation, left atrial-distal bypass and recombinant factor VIIa. Post-operative haemoglobin levels were maintained, but a left haemothorax necessitated re-thoracotomy on post-operative day 4. Following re-thoracotomy, Hb was 12.0 g.dL—1 and platelet count 49 × 109.L—1. Recombinant erythropoietin was recommenced. At discharge (day 12), Hb was 10.1 g.dL—1. The patient remains well at one year. A thoroughly, pre-planned multi-disciplinary blood conservation strategy can be used to undertake high-risk procedures.Perfusion (2007) 22, 363—364.
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References
1.
Kouchoukos NT , Wareing TH, Izumoto H., Klausing W., Abboud N.Elective hypothermic cardiopulmonary bypass and circulatory arrest for spinal cord protection during operations on the thoracoabdominal aorta. J Thorac Cardiovasc Surg1990; 99: 659—64.
2.
Life Application Study Bible.New King James Version6th Ed. Wheaton, Illinois: Tyndale House Publishers, INC; 1996. Genesis 9:4, Leviticus 17:14, Acts 15: 29.
3.
Gaudiani VA, Mason DWPreoperative erythropoietin in Jehovah's Witness who require cardiac procedures . Ann Thorac Surg1991; 51(5): 823—24.
4.
Scottish Intercollegiate Guidelines Network.Perioperative blood transfusion for elective surgery October 2001; guideline no 54.
5.
Westaby S., Parry AJ, Lamont P., Grebenik C.Massive descending thoracic aneurysm in a Jehovah's Witness: treatment by thromboexclusion. Ann Thorac Surg1993; 55: 1233—35.
