Hernández-Navarrete Liliana Stefany, Hernández-Jiménez Jesús Diego, Jiménez-López Luis Alfredo, Budar-Fernández Luis Filadelfo, Méndez-López Marco Tulio, Martínez-Mier Gustavo
Universidad Anáhuac México Norte, Veracruz, Veracruz, Mexico.
Universidad Juárez Autónoma de Tabasco, Mexico.
Cir Cir. 2013 Sep-Oct;81(5):450-3.
Jehovah's Witness refuse blood transfusion, but they accept organ transplantation, albumin, immunoglobulin, vaccines and clotting factors.
We present 3 kidney transplants in Jehovah's Witness patients (two male and one female) without blood transfusion, with a mean age of 31.33 years and a mean body mass index of 20.99 kg/m(2). All patients underwent pretransplant peritoneal dialysis for an average of 52.3 months. Two transplants came from living donors and one from a deceased donor with a cold ischemia of 23 hours. The donors were two females and one male, with a mean age of 34.33 years. All patients received pretransplant erythropoietin and iron dextran and an intraoperative cell saver was used. Hemoglobin, hematocrit, red blood cells and serum creatinine levels, as well as the glomerular filtration at 24 months postransplant were stable. All patients received induction with basiliximab and initial immunosuppression with calcineurin inhibitors. One of the patients had a perirenal hematoma as a complication, which required a surgery 20 days post-transplant. At 5, 26 and 36 months postransplant the three patients are alive and with functional grafts.
It is possible to perform kidney transplantation without transfusion in Jehovah's Witness, obtaining an acceptable global survival without acute rejection.
耶和华见证人拒绝输血,但接受器官移植、白蛋白、免疫球蛋白、疫苗和凝血因子。
我们报告了3例耶和华见证人患者的肾移植手术(2例男性,1例女性),未进行输血,平均年龄31.33岁,平均体重指数20.99kg/m²。所有患者术前平均接受了52.3个月的腹膜透析。2例移植来自活体供体,1例来自脑死亡供体,冷缺血时间为23小时。供体为2例女性和1例男性,平均年龄34.33岁。所有患者术前均接受促红细胞生成素和右旋糖酐铁治疗,并在术中使用了细胞回收装置。血红蛋白、血细胞比容、红细胞和血清肌酐水平,以及移植后24个月的肾小球滤过率均保持稳定。所有患者均接受巴利昔单抗诱导治疗,并以钙调神经磷酸酶抑制剂进行初始免疫抑制。其中1例患者术后出现肾周血肿并发症,于移植后20天接受了手术治疗。移植后5个月、26个月和36个月时,3例患者均存活,移植肾功能良好。
耶和华见证人患者可以在不输血的情况下进行肾移植,获得可接受的总体生存率且无急性排斥反应。