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"Bloodless" Neurosurgery Among Jehovah's Witnesses: A Comparison with Matched Concurrent Controls.

Douglas A Hardesty1, Sean Doerfler1, Sukhmeet Sandhu1

  • 1Department of Neurosurgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.

World Neurosurgery
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Summary

Neurosurgery for Jehovah's Witnesses (JW) is safe and feasible within a blood management program. Outcomes are comparable to patients accepting transfusions, demonstrating effective care strategies for this population.

Keywords:
Jehovah's WitnessNeurosurgeryTransfusion

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Area of Science:

  • Neurosurgery
  • Transfusion Medicine
  • Patient Blood Management

Background:

  • Jehovah's Witnesses (JW) decline autologous blood transfusions, posing management challenges in neurosurgery.
  • Optimal neurosurgical care for JW patients requires specific protocols.
  • This study investigates the safety and feasibility of neurosurgery for JW within a blood management program.

Purpose of the Study:

  • To evaluate the safety and feasibility of neurosurgical procedures for Jehovah's Witnesses (JW).
  • To compare outcomes of JW patients undergoing neurosurgery with a matched control group.

Main Methods:

  • Retrospective review of 68 JW patients undergoing cranial or spinal neurosurgery over 5 years.
  • Comparison with a concurrent cohort of sex-, age-, and procedure-matched non-JW controls.
  • Analysis of hospital charts, anesthetic records, and operative reports.

Main Results:

  • Cell-saving systems used in 27 cases; blood retransfused in 13.
  • Median hemoglobin decrease was 2.1 g/dL; one patient had postoperative hemoglobin <7 g/dL.
  • No major complications like sepsis or cardiopulmonary events observed; outcomes similar to controls.

Conclusions:

  • Neurosurgical procedures are feasible and safe for Jehovah's Witnesses (JW) when managed in a multidisciplinary blood management program.
  • Outcomes for JW patients are comparable to those accepting transfusions.
  • Multidisciplinary blood management is key for successful neurosurgery in JW patients.