Ito Kae, Koyama Motohiro, Ueyama Keishi
Department of Cardiovascular Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan.
Kyobu Geka. 2019 Feb;72(2):136-139.
Cardiac surgery in Jehovah's witnesses is challenging due to their refusal of blood transfusion. Furthermore, dialysis patients often suffer from anemia and are also prone to bleeding. We performed offpump coronary artery bypass grafting (CABG) [OPCAB] on a Jehovah's witness male patient on hemodialysis. His preoperative hemoglobin level was around 10.0 g/dl. We used cell saver-collected blood as much as possible during operation. His postoperative course was uneventful with the lowest hemoglobin level of 7.2 g/dl using iron supplements and erythropoietin. This case indicates that intraoperative blood salvage and perioperative management of anemia make OPCAB without blood transfusion possible even in Jehovah's witness hemodialysis patients, when their preoperative hemoglobin levels are maintained greater than 10.0 g/dl.
由于耶和华见证会成员拒绝输血，为他们进行心脏手术具有挑战性。此外，透析患者常患有贫血，且容易出血。我们为一名正在接受血液透析的耶和华见证会男性患者进行了非体外循环冠状动脉旁路移植术（OPCAB）。他术前的血红蛋白水平约为10.0 g/dl。我们在手术中尽可能多地使用了自体血回输收集的血液。他术后恢复顺利，通过补充铁剂和促红细胞生成素，血红蛋白水平最低为7.2 g/dl。该病例表明，当耶和华见证会血液透析患者术前血红蛋白水平维持在大于10.0 g/dl时，术中血液回收及围手术期贫血管理使得不输血进行OPCAB成为可能。
