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Perfusion
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Thoraco-abdominal aneurysm repair in a Jehovah's Witness: maximising blood conservation

I.A. Rahman

Departments of Cardiothoracic Surgery, University Hospital Birmingham NHS Trust, Birmingham, UK

T. Hoth

Anaesthesia, University Hospital Birmingham NHS Trust, Birmingham, UK

H. Doughty

Transfusion Medicine, University Hospital Birmingham NHS Trust, Birmingham, UK

R.S. Bonser

Departments of Cardiothoracic Surgery, University Hospital Birmingham NHS Trust, Birmingham, UK, robert.bonser{at}uhb.nhs.uk

Thoraco-abdominal aneurysm repair usually necessitates blood or blood product transfusion which is prohibited in Jehovah's Witnesses. We report the blood conservation strategy used during thoraco-abdominal aneurysm repair in a Jehovah's Witness. This included pre-operative recombinant erythropoietin, per-operative acute normovolaemic haemodilution, cell salvage, aprotinin, restricted heparinisation, left atrial-distal bypass and recombinant factor VIIa. Post-operative haemoglobin levels were maintained, but a left haemothorax necessitated re-thoracotomy on post-operative day 4. Following re-thoracotomy, Hb was 12.0 g.dL—1 and platelet count 49 x 109.L—1. Recombinant erythropoietin was recommenced. At discharge (day 12), Hb was 10.1 g.dL—1. The patient remains well at one year. A thoroughly, pre-planned multi-disciplinary blood conservation strategy can be used to undertake high-risk procedures. Perfusion (2007) 22, 363—364.

Perfusion, Vol. 22, No. 5, 363-364 (2007)
DOI: 10.1177/0267659107084525
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