"Bloodless" Neurosurgery Among Jehovah's Witnesses: A Comparison with Matched Concurrent Controls

[Guest Nicole]

Highlights

•Neurosurgical outcomes in patients who refuse blood products are similar to control patients when blood management protocols are followed

•No significant differences in mortality or morbidity were identified

•No significant differences in hospital length of stay or readmission rates were identified

Abstract

Background

Jehovah's Witnesses (JW) are a Christian faith with > 1 million members in the United States who do not accept autologous blood transfusions. The optimal management of these patients undergoing neurosurgical procedures is not well defined. Here, we examined the feasibility and safety of JW undergoing neurosurgery in a blood management program.

Study Design and Methods

Sixty-eight JW patients including 23 males and 45 females (mean age 53 +/- 12 years) who underwent a variety of cranial (n=19) and spinal (n=49) neurosurgical procedures over a 5-year period were identified retrospectively and their hospital charts, anesthetic records and operative reports reviewed. A concurrent cohort of sex - age- and procedure-matched non-JW controls also was identified.

Results

Among JW patients a cell-saving system was used in 27 cases, with blood re-transfused in 13 cases. Lactated Ringers solution was used extensively intra-operatively; albumin was given to 15 patients. The median decrease in Hgb was 2.1 g/dL. One patient had a postoperative Hgb value < 7 g/dL. One patient returned to the operating room to revise a lumbar pedicle screw, and one patient had postoperative seizures. No cardiopulmonary complications, sepsis, pneumonia, or wound infection were observed. When compared to the matched control group, similar outcome results were observed. Blood loss and operative time also were similar in JW patients and controls.

Conclusions

Neurosurgical procedures in Jehovah's Witnesses are feasible, safe, and have similar outcomes to patients willing to accept transfusion when managed within a multidisciplinary blood management program.

http://www.worldneurosurgery.org/article/S1878-8750(16)30854-3/abstract

[Stephen Perkins]

I had neurosurgery.  My Surgeon ask me how certain I was about not taking blood.  I replied that when Noah got off the ark, and the  rainbow covenant was made, we were allowed to eat meat, but must pour the blood out on the ground.  Jewish covenant, not allowed to eat blood. Christian covenant, Acts 15:28,29 "abstain from blood".  Never has any servant of God EVER been allowed to eat blood, or take it into their body.  When people are facing death, that's usually a time when they try to make peace with God.  As I am being operated upon, and things go south, my life is hanging by a thread, why would I want my last act on God's green earth to be thumbing my nose at my creator?