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Transfusion-free cardiopulmonary bypass in four Jehovah's Witness' patients weighing less than 5 kg

Zeitschrift fur Herz-, Thorax- und Gefasschirurgie, ISSN: 0930-9225, Vol: 20, Issue: 5, Page: 181-188
2006
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Article Description

Jehovah's Witnesses reject blood transfusions on the grounds of their literal interpretation of passages of the Bible. In accordance with this belief, Jehovah's Witnesses feel that it is also forbidden to retransfuse autologous blood that has been separated from their own circulatory system. Thus, performing cardiac surgery in pediatric Jehovah's Witness patients is a great challenge for the surgical team. We report the use of cardiopulmonary bypass (CPB) during open-heart surgery in four patients with body weights of 3.1 kg, 3.5 kg, 4.2 kg and 4.5 kg, respectively, without transfusion of blood components. To reduce the risk of surgery in these patients, a very small extracorporeal circuit was designed to decrease the amount of priming volume and thereby the degree of hemodilution. A dedicated pediatric heart-lung machine console with remote pump heads and intensive blood conservation efforts allowed the operation without the use of donor blood. The CPB circuits were primed with crystalloid solution only. The procedures were performed in normothermia or in moderate hypothermia. The patients did not receive any blood or blood products during their entire hospital stay. © 2006 Steinkopff-Verlag.

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