High risk cardiac surgery in Jehovah's Witnesses

Much routine cardiovascular surgery can be performed without blood transfusion. Complex cardiac surgical procedures, however, especially reoperations, are often associated with heavy blood loss and large transfusion requirements. Anaesthetists and surgeons caring for patients who are Jehovah's Witnesses may be unwilling to offer such high risk surgery without recourse to blood transfusion. We report six such cases which were successfully performed without the use of blood or blood products and discuss the techniques used. Three of the patients described had been refused surgery, on their terms, at other centres. We believe that no patient should be denied potentially life saving surgery on the grounds of excessive risk without blood transfusion.