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Heart transplant in Jehovah's Witness patients: A case-control study

Sukhjot Sander1, Tahli Singer-Englar2, Keith Nishihara3

  • 1Department of Internal Medicine, Smidt Heart Institute, Cedars-Sinai, Los Angeles, California.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|April 11, 2021
PubMed

Insights

Heart transplantation is a viable option for Jehovah's Witnesses (JW) patients who decline blood transfusions. Carefully selected JW recipients demonstrated comparable outcomes to non-JW patients one year post-heart transplant.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Medical Ethics

Background:

  • Heart transplantation (HTx) offers improved survival and quality of life for advanced heart failure patients.
  • Jehovah's Witnesses (JW) patients' refusal of blood transfusions presents challenges for HTx candidacy at many institutions.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of heart transplantation in Jehovah's Witnesses (JW) patients who decline blood products.
  • To compare the outcomes of JW HTx recipients with non-JW control patients.

Main Methods:

  • Retrospective review of 20 consecutive JW patients referred for HTx consideration.
  • Analysis of 8 JW patients who underwent HTx and comparison with matched non-JW controls without prior cardiac surgery.
  • Assessment of primary graft dysfunction, rejection, allograft vasculopathy, survival, and hemoglobin levels up to 1 year post-transplant.

Main Results:

  • Seven of 20 JW patients were declined HTx for specific medical reasons.
  • Eight JW patients underwent HTx and showed comparable rates of primary graft dysfunction, rejection, and allograft vasculopathy to controls.
  • Survival and hemoglobin levels were similar between JW and non-JW HTx recipients at 1 year.

Conclusions:

  • Heart transplantation can be successfully performed in selected Jehovah's Witnesses (JW) patients who decline blood products.
  • Appropriate patient selection is crucial for achieving favorable outcomes in this patient population.
  • This study supports the expansion of HTx candidacy for JW patients adhering to their religious beliefs.

Keywords:
Jehovah's Witnessbloodless transplantationheart transplantation

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