Jehovah's Witnesses: Challenges in liver disease management and in liver transplantation.

Patients of Jehovah's Witnesses faith who are in need of liver transplantation pose unique challenges. These patients should be seen at transplant centers with experience in caring for Jehovah's Witnesses to formulate careful preoperative, intraoperative, and postoperative strategies on an individualized basis with multidisciplinary input to mitigate the risk of bleeding complications and to prepare for potentially catastrophic scenarios. In-depth and individualized conversations about what constitutes acceptable bloodless transfusion strategies both for the patient and for the transplant center should begin as early as possible with an experienced coordinator or church liaison. A therapeutic physician-patient relationship is vital to formulating a safe care plan and to understanding the spectrum of beliefs among Jehovah's Witnesses. There remains a paucity of data on disparities in liver care and outcomes in patients of the Jehovah's Witnesses faith. Future research on liver diseases and liver transplantation in Jehovah's Witnesses should focus on creating registries of patient outcomes and centers with experience.