Ep03 a Good Blood Management Is Not an Option. It Is Possible to Treat an Aortic Dissection in Jehovah's Witnesses in Emergency?

Abstract

Background: Jehovah's Witness are convinced that biblical passages prohibit the transfusion of allogeneic blood and the predeposit of autologous whole blood for subsequent reinfusion. Medical literature reports several cases of complex medical and surgical procedures performed successfully without the use of allogeneic blood transfusions or its main components. In order to avoid blood transfusions, it is essential to use clinical strategies to minimize blood loss, to save autologous whole blood (AWB), to enhance hematopoiesis and to optimize the tolerance of anemia Methods: Herein we present a case of 71 years old manwith acute aortic dissection in a Jehovah's Witness patient (JW). Is a rare condition. Respecting the patient's will, a surgical procedure in high-risk surgical emergencywas performed without the use of blood transfusions,but applying our “bloodless protocol”, which can be considered as an extreme patient blood management protocol (PBM), in which the aim is to avoid the need for transfusions. Conclusion: Scientific literature and our twenty-year-experience with JW patients allowed us to show how an adequate strategy, a concrete project and a multidisciplinary bloodlessteam can guarantee excellent results either in JW patients or alternatively in specific cases ofalteration of the coagulationsystem, even in emergency situations. A well-defined strategic plan can help reduce duration of hospitalization and hospital cost. This case report, suggests that high quality PBM could be reasonably extended to all patients admitted to hospital, with the vision that “we treat all patients like JWs”.