Dallas Torijaun, Welsby Ian, Bottiger Brandi, Milano Carmelo, Daneshmand Mani, Guinn Nicole
From the Department of Cardiothoracic Anesthesiology, Duke University Medical Center, Durham, North Carolina.
A A Case Rep. 2015 May 15;4(10):140-2. doi: 10.1213/XAA.0000000000000067.
We present the case of a 53-year-old female Jehovah's Witness with nonischemic cardiomyopathy who successfully underwent a bloodless heart transplantation using fibrinogen concentrate (RiaSTAP; CSL Behring, King of Prussia, PA) and other blood-conservation methods. With a multidisciplinary team and the use of preoperative erythropoietin-stimulating drugs, normovolemic hemodilution, cell salvage, and pharmacotherapy to prevent and treat coagulopathy, we were able to maintain hemoglobin levels greater than 11 g/dL without the need for blood transfusion. We conclude that orthotopic heart transplants may be performed successfully in select Jehovah's Witness patients using standard and novel blood conservation methods.
我们报告了一例53岁患非缺血性心肌病的耶和华见证会女性患者，她使用纤维蛋白原浓缩物（RiaSTAP；CSL Behring公司，宾夕法尼亚州普鲁士王镇）及其他血液保护方法成功接受了非输血心脏移植手术。通过多学科团队协作，并使用术前促红细胞生成素刺激药物、正常血容量血液稀释、细胞回收以及预防和治疗凝血功能障碍的药物治疗，我们得以在无需输血的情况下将血红蛋白水平维持在大于11 g/dL。我们得出结论，通过标准和新型血液保护方法，可成功为部分耶和华见证会患者实施原位心脏移植手术。
