PERIOPERATIVE STRATEGIES AND SURGERY BASED ON PATIENT BLOOD MANAGEMENT FOR JEHOVAH'S WITNESS PATIENTS WITH DIGESTIVE TUMORS

• Published in: Japanese Journal of Transfusion and Cell Therapy Vol. 65; no. 3; pp. 577 - 583
• Main Authors: Kawamoto, Shunji, Terashima, Takahiro, Kurogi, Norimitsu, Noritomi, Tomoaki, Maeno, Hiroshi
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Transfusion Medicine and Cell Therapy 25.06.2019
• Subjects: Bloodless surgery and medicine; Cancer; Jehovah's Witness; PBM
• ISSN: 1881-3011; 1883-0625
• DOI: 10.3925/jjtc.65.577

We report 217 cases in which blood alternatives and surgery based on Patient Blood Management (PBM) were performed in patients who are Jehovah's Witnesses. The diseases included 4 cases of esophageal cancer, 51 of gastric cancer, 75 of colorectal cancer, 37 of liver cancer, 16 of bile duct cancer, 25 of pancreatic cancer and 10 of other organ tumors. Forty-one patients with anemia were treated by employing preoperative blood augmentation, all of whom were enabled to receive planned resection. The frequency of using autologous blood transfusion was 48% overall, in which most of the high-level hepato-biliary-pancreatic surgeries were integrated by a combination of hemodilutional and salvaged autotransfusion. Postoperative care included administration of an iron infusion and minor components if needed. Postoperative complications were observed at the rate of 3.1%, all of which were well-managed by closemonitoring of surgical drainage. PBM, which consists of multidisciplinary management involving blood augmentation and autologous blood transfusion, enabled surgical treatment of Jehovah's Witness patients that contributed to their better prognosis.