Transfusion Dilemma/Coagulation TEG

Abstract

The healthcare team is presented with a unique challenge when providing bloodless surgery to patients of the Jehovah’s Witness faith who refuse allogenic transfusions based on religious beliefs. The Jehovah’s Witness faith interprets New and Old Testament passages of the Bible, including Genesis 9:4, as God commanding against “eating blood,” thus preventing believers from receiving transfusions of blood products. When it comes to complex cardiac surgery, where blood loss and coagulopathy are common, the physician and patient must establish a plan for blood conservation and optimization of hemoglobin preoperatively. Knowledge of management options during the preoperative period as well as treatment options for blood loss is imperative to honor patient autonomy and avoid ethical dilemmas.