Blood transfusions in anemic patients frequently are used for critically ill patients as a life-saving therapeutic maneuver. Jehovah’s Witness (JW) patients typically refuse blood transfusions due to religious beliefs. Numerous clinical reports, in a wide spectrum of medical specialties, have shown no greater morbidity or mortality in JW patients or others who refused transfusions compared to those patients who accept transfusions. We report our experience with two JW patients who presented with severe anemia and life-threatening pancreatitis. Despite undergoing percutaneous drainages by interventional radiology (IR) for complex pancreatic collections (and other IR drainages), neither patient suffered any adverse effect from the IR procedures, even though they refused blood transfusions. Our experience suggests that IR procedures also may be successful with this more limited blood product protocol.
HughesDBUlleryBWBariePS. The contemporary approach to the care of Jehovah’s Witnesses. J Trauma. 2008;65(1):237–247.
2.
SimpsonJ. Nursing with dignity: Jehovah’s Witnesses. Nurs Times. 2002;98(17):36–37.
3.
StamouSCWhiteTBarnettSBoyceSWCorsoPJLefrakEA. Comparisons of cardiac surgery outcomes in Jehovah’s versus non-Jehovah’s Witnesses. Am J Cardiol. 2006;98(9):1223–1225.
4.
EmmertMYSalzbergSPTheusingerOM. How good patient blood management leads to excellent outcomes in Jehovah’s Witness patients undergoing cardiac surgery. Interact Cardiovasc Thorac Surg. 2011;12(2):183–188.
5.
MoracaRJWanamakerKMBaileySH. Strategies and outcomes of cardiac surgery in Jehovah’s Witnesses. J Cardiac Surg. 2011;26(2):135–143.
6.
NelsonCLStewartJG. Primary and revision total hip replacement in patients who are Jehovah’s Witnesses. Clin Orthop Relat Res. 1999;(369):251–261.
7.
BowenJRAngusPDHuxsterRRMacEwenGD. Posterior spinal fusion without blood replacement in Jehovah’s Witnesses. Clin Orthop Relat Res. 1985;(198):284–288.
8.
MoskowitzDMPerelmanSICousineauKM. Multidisciplinary management of a Jehovah’s Witness patient for the removal of a renal cell carcinoma extending into the right atrium. Can J Anesth. 2002;49(4):402–408.
9.
RoenPRVelcekF. Extensive urologic surgery without blood transfusion. N Y State J Med. 1972; 72(20):2524–2527.
10.
ReesMPlantGWellsJBygraveS. One hundred and fifty hepatic resections: evolution of technique towards bloodless surgery. Br J Surg. 1996;83(11):1526–1529.
11.
SuessSSuessOBrockM. Neurosurgical procedures in Jehovah’s Witnesses: an increased risk?Neurosurgery. 2001;49(2):266–272.
12.
DeCastroRM.Bloodless surgery: establishment of a program for the special medical needs of the Jehovah’s Witness community—the gynecologic surgery experience at a community hospital. Am J Obstetr Gynecol. 1999;180(6 pt 1):1491–1498.
13.
BoydMESoucyRFalconeT. The morbidity of hysterectomy among Jehovah’s Witnesses. J Pelvic Surg. 1996;2:63–67.
14.
JabbourNGagandeepSMateoR. Live donor liver transplantation without blood products: strategies developed for Jehovah’s Witnesses offer broad application. Ann Surg. 2004;240(2):350–357.
15.
GutierrezGBrothertonJ. Management of severe anemia secondary to menorrhagia in a Jehovah’s Witness: case report and treatment algorithm. Am J Obstet Gynecol. 2011;205(2):e5–e8.
16.
BonakdarMIEckhousAWBacherBJTabbilosRHPeisnerDB. Major gynecologic and obstetric surgery in Jehovah’s Witnesses. Obstetr Gynecol. 1982;60(5):587–590.
17.
SalpeterSRBuckleyJSChatterjeeS. Impact of more restrictive blood transfusion strategies on clinical outcomes: a meta-analysis and systematic review. Am J Med. 2014;127(2):124–131.
18.
PattakosGKochCGBrizzioME. Outcome of patients who refuse transfusion after cardiac surgery: a natural experiment with severe blood conservation. Arch Intern Med. 2012;172(15):1154–1160
19.
VillanuevaCColomoABoschA. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013;368(1):11–21
20.
LaineL. Upper gastrointestinal bleeding due to a peptic ulcer. N Engl J Med. 2016;374(24):2367–2376.
21.
vanSonnenbergEWittichGRChonKS. Percutaneous radiologic drainage of pancreatic abscesses. AJR Am J Roentgenol. 1997;168(4):979–984.
22.
VarelaJEGomez-MarinOFlemingLECohnSM. The risk of death for Jehovah’s Witnesses after major trauma. J Trauma. 2003;54(5):967–972.
23.
NelsonBSHeiskellLECemajSO’CallaghanTAKollerCE. Traumatically injured Jehovah’s Witnesses: a sixteen year experience of treatment and transfusion dilemmas at a level 1 trauma center. J Trauma. 1995;39(4):681–685.
24.
de Araújo AziLMLopesFMGarciaLV. Postoperative management of severe acute anemia in a Jehovah’s Witness. Transfusion. 2014;54(4):1153–1157.
25.
UkachiNMorrisonWVanhornSSundaramRLantosJD. A young adult Jehovah’s Witness with severe anemia. Pediatrics. 2013;132(3):547–551.
26.
AgapidouAVakalopoulouSPapadopoulouTChadjiaggelidouCGarypidouV. Successful treatment of severe anemia using erythropoietin in a Jehovah Witness with non-Hodgkin lymphoma. Hematol Rep. 2014;6(4):5600.
27.
VincentJLBaronJFReinhartK. Anemia and blood transfusion in critically ill patients. JAMA. 2002;288(12):1499–1507.
28.
FergussonDvanWalravanCCoyleDLaupacisA. Economic evaluation of technologies to minimize perioperative transfusion. A systematic review of published studies. Transfusion Medicine Review. 1999;13(2):106–117.
