Published online Sep 26, 2019. doi: 10.5500/wjt.v9.i5.94
Peer-review started: June 23, 2019
First decision: August 2, 2019
Revised: August 14, 2019
Accepted: September 13, 2019
Article in press: September 16, 2019
Published online: September 26, 2019
Managing blood loss in Jehovah’s Witness (JW) patients is a matter of controversy. These patients will not accept transfusions of red blood cells, white blood cells, platelets or plasma, even if that is required to save their lives. There are many discussions regarding safety of operating upon JW patients in general surgical procedures, but in solid organ transplantation there is a paucity of literature on this subject. We have reviewed individual case reports and small series documenting on experience with solid organ transplantation in JW patients and the strategies adopted to facilitate that. It is clear that such patients require the surgical team to dedicate more time to ensure their safe management. This begins with a thorough, detailed consent of exactly which products and interventions they will or will not accept. Planning must begin weeks before surgery if possible. Each case must be assessed individually, but provided they meet fitness requirements, there are no absolute contraindications to abdominal organ transplantation.
Core tip: There is a fairly limited global experience in solid organ transplantation in Jehovah’s Witness patients. We have reviewed and consolidated the literature available in addition to reviewing blood products administration in Jehovah’s Witness patients undergoing solid organ transplantation. We have also highlighted the complexity of the consent and pre-operative planning involved prior to solid organ transplantation in these patients.