MANAGEMENT OF JEHOVAH-WITNESS PATIENTS FOR SCOLIOSIS SURGERY - THE USE OF PLATELET AND PLASMAPHERESIS

Four patients whose religious beliefs prohibited accepting blood durin g surgery for scoliosis were anesthetized and managed successfully usi ng plateletpheresis and plasmapheresis. Blood losses were replaced wit h crystalloid and hetastarch solutions. In addition, a moderate hypote nsive technique was used to minimize surgical blood loss. Postoperativ ely, the patients received iron therapy and/or erythropoietin. Three o f these patients had an uncomplicated postoperative course; however, t he fourth patient had some postoperative bleeding with initial hemodyn amic instability. We believe that patients who refuse to receive blood transfusion during surgery because of religious beliefs or health iss ues can be managed safely using-other alternatives and techniques such as plateletpheresis and plasmapheresis, which conserve and minimize b lood loss. Each case should be assessed on an individual basis. (C) 19 97 by Elsevier Science Inc.