Korean J Hepatobiliary Pancreat Surg.  2016 Aug;20(3):121-126. 10.14701/kjhbps.2016.20.3.121.

Successful transfusion-free pancreatectomy in Jehovah's Witness patients

• Lee JO
• Kim DW
• Jeong MA
• Lee HJ
• Kim KN
• Choi D

• KMID: 2351299
• DOI: http://doi.org/10.14701/kjhbps.2016.20.3.121

Abstract

BACKGROUNDS/AIMS
Although perioperative therapies have improved greatly, pancreatectomies still often need blood transfusions. However, the morbidity from blood transfusions, the poor prognosis of blood transfused patients, high cost, and decreasing supply of blood products is accelerating transfusion-free (TF) surgery in the patients who have pacreatectomies. The aim of this study was to assess the feasibility of TF pancreatectomies for patients who are Jehovah's Witness.
METHODS
We investigated the possibility of TF pancreatectomies for the Jehovah's Witness patients undergoing pancreatectomies between January 2007 and Februay 2014. There were 4 cases of Whipple's operation, 4 of pylorus-preserving pancreaticoduodenectomy, 2 of radical antegrade modular pancreatosplenectomy and 1 of laparoscopic distal pancreatectomy. All were performed by one surgeon.
RESULTS
Most of the TF pancreatecomies patients received perioperative blood augmentation and intraoperative acute normovolemic hemodilution (ANH). They received no blood transfusions at any time during their hospitalization, and pre- and intra-operative data and outcomes were acceptably favorable.
CONCLUSIONS
To the best of our knowledge, this report is the first successful consecutive pancreatectomy program for Jehovah's Witness not involving blood transfusion. TF pancreatectomy can be performed successfully in selected Jehovah's Witness. Postoperative prognosis and outcomes should be confirmed in follow up studies.

Keyword

Transfusion-free surgery; Pancreatectomy; Jehovah's Witness

MeSH Terms

Blood Transfusion
Bloodless Medical and Surgical Procedures
Follow-Up Studies
Hemodilution
Hospitalization
Humans
Pancreatectomy*
Pancreaticoduodenectomy
Prognosis

Figure

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  Fig. 1 Mean operative hemoglobin levels of eleven patients. No significant differences between blood augmentation group and all patients.

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