LIVER TRANSPLANTATION IN JEHOVAH'S WITNESSES PATIENTS IN A CENTER OF NORTHEASTERN BRAZIL

Context Liver transplantation has been accepted as a therapeutic option for patients with end-stage liver disease and acute liver failure. Currently, Brazil has a well-established public organ transplant program, performing 7,425 solid organs transplants in 2012 alone, among which 1,595 were liver transplants. Jehovah's Witnesses report 7,6 million members worldwide. For religious reasons they refuse transfusion of whole blood or its primary components (red cells, fresh frozen plasma, platelets). Objective This study aims to present the results obtained with Jehovah's Witnesses patients by a liver transplantation service. Method We conducted a retrospective review of medical records from Jehovah's Witnesses patients (n = 4) who underwent orthotopic liver transplantation from September 2009 to September 2011 at the Walter Cantídio University Hospital of the Federal University of Ceará, Fortaleza, CE, Brazil. Coagulation parameters such as Hemoglobin, Hematocrit, Platelets, INR were evaluated during the preoperative, immediate postoperative, postoperative day (POD) 7 and POD 30. Results Coagulation parameters were expressed as means: hematocrit, 35.07% ± 6.65%, 24.6% ± 4.74%, 19.85% ± 2.10%, 31.85% ± 5.99%; hemoglobin, 12.57 g/dL ± 2.22, 8.92 g/dL ± 1.75, 6.92 g/dL ± 0.58, 11.17 g/dL ± 0.9; platelets, 160,975 mm 3 ± 148000, 128,000 mm 3 ± 34836, 65,000 mm 3 ± 33496, 234,250 mm 3 ± 287003 and INR, 143 ± 0.10, 2.4 ± 0.34, 1.24 ± 0.10, 1.14 ± 0.09. Conclusion Liver transplantation can successfully be performed in Jehovah's Witnesses patient population provided that: 1) the medical team has extensive expertise in that field, 2) the patient has an adequate level of hematologic factors preoperatively, and 3) there is availability of specialized equipment such as cell saver to minimize blood loss and thus avoid transfusion requirements.

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Main Authors: GARCIA,José Huygens Parente, COELHO,Gustavo Rego, FEITOSA NETO,Bartolomeu Alves, NOGUEIRA,Emmanuel Almeida, TEIXEIRA,Cayo César Góis, MESQUITA,Denissa Ferreira Gomes
Format: Digital revista
Language:English
Published: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. 2013
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032013000200138
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spelling oai:scielo:S0004-280320130002001382014-04-16LIVER TRANSPLANTATION IN JEHOVAH'S WITNESSES PATIENTS IN A CENTER OF NORTHEASTERN BRAZILGARCIA,José Huygens ParenteCOELHO,Gustavo RegoFEITOSA NETO,Bartolomeu AlvesNOGUEIRA,Emmanuel AlmeidaTEIXEIRA,Cayo César GóisMESQUITA,Denissa Ferreira Gomes Liver transplantation Jehovah's Witnesses Religion and medicine Blood transfusion, ethics Brazil Context Liver transplantation has been accepted as a therapeutic option for patients with end-stage liver disease and acute liver failure. Currently, Brazil has a well-established public organ transplant program, performing 7,425 solid organs transplants in 2012 alone, among which 1,595 were liver transplants. Jehovah's Witnesses report 7,6 million members worldwide. For religious reasons they refuse transfusion of whole blood or its primary components (red cells, fresh frozen plasma, platelets). Objective This study aims to present the results obtained with Jehovah's Witnesses patients by a liver transplantation service. Method We conducted a retrospective review of medical records from Jehovah's Witnesses patients (n = 4) who underwent orthotopic liver transplantation from September 2009 to September 2011 at the Walter Cantídio University Hospital of the Federal University of Ceará, Fortaleza, CE, Brazil. Coagulation parameters such as Hemoglobin, Hematocrit, Platelets, INR were evaluated during the preoperative, immediate postoperative, postoperative day (POD) 7 and POD 30. Results Coagulation parameters were expressed as means: hematocrit, 35.07% ± 6.65%, 24.6% ± 4.74%, 19.85% ± 2.10%, 31.85% ± 5.99%; hemoglobin, 12.57 g/dL ± 2.22, 8.92 g/dL ± 1.75, 6.92 g/dL ± 0.58, 11.17 g/dL ± 0.9; platelets, 160,975 mm 3 ± 148000, 128,000 mm 3 ± 34836, 65,000 mm 3 ± 33496, 234,250 mm 3 ± 287003 and INR, 143 ± 0.10, 2.4 ± 0.34, 1.24 ± 0.10, 1.14 ± 0.09. Conclusion Liver transplantation can successfully be performed in Jehovah's Witnesses patient population provided that: 1) the medical team has extensive expertise in that field, 2) the patient has an adequate level of hematologic factors preoperatively, and 3) there is availability of specialized equipment such as cell saver to minimize blood loss and thus avoid transfusion requirements. info:eu-repo/semantics/openAccessInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. Arquivos de Gastroenterologia v.50 n.2 20132013-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032013000200138en10.1590/S0004-28032013000200023
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author GARCIA,José Huygens Parente
COELHO,Gustavo Rego
FEITOSA NETO,Bartolomeu Alves
NOGUEIRA,Emmanuel Almeida
TEIXEIRA,Cayo César Góis
MESQUITA,Denissa Ferreira Gomes
spellingShingle GARCIA,José Huygens Parente
COELHO,Gustavo Rego
FEITOSA NETO,Bartolomeu Alves
NOGUEIRA,Emmanuel Almeida
TEIXEIRA,Cayo César Góis
MESQUITA,Denissa Ferreira Gomes
LIVER TRANSPLANTATION IN JEHOVAH'S WITNESSES PATIENTS IN A CENTER OF NORTHEASTERN BRAZIL
author_facet GARCIA,José Huygens Parente
COELHO,Gustavo Rego
FEITOSA NETO,Bartolomeu Alves
NOGUEIRA,Emmanuel Almeida
TEIXEIRA,Cayo César Góis
MESQUITA,Denissa Ferreira Gomes
author_sort GARCIA,José Huygens Parente
title LIVER TRANSPLANTATION IN JEHOVAH'S WITNESSES PATIENTS IN A CENTER OF NORTHEASTERN BRAZIL
title_short LIVER TRANSPLANTATION IN JEHOVAH'S WITNESSES PATIENTS IN A CENTER OF NORTHEASTERN BRAZIL
title_full LIVER TRANSPLANTATION IN JEHOVAH'S WITNESSES PATIENTS IN A CENTER OF NORTHEASTERN BRAZIL
title_fullStr LIVER TRANSPLANTATION IN JEHOVAH'S WITNESSES PATIENTS IN A CENTER OF NORTHEASTERN BRAZIL
title_full_unstemmed LIVER TRANSPLANTATION IN JEHOVAH'S WITNESSES PATIENTS IN A CENTER OF NORTHEASTERN BRAZIL
title_sort liver transplantation in jehovah's witnesses patients in a center of northeastern brazil
description Context Liver transplantation has been accepted as a therapeutic option for patients with end-stage liver disease and acute liver failure. Currently, Brazil has a well-established public organ transplant program, performing 7,425 solid organs transplants in 2012 alone, among which 1,595 were liver transplants. Jehovah's Witnesses report 7,6 million members worldwide. For religious reasons they refuse transfusion of whole blood or its primary components (red cells, fresh frozen plasma, platelets). Objective This study aims to present the results obtained with Jehovah's Witnesses patients by a liver transplantation service. Method We conducted a retrospective review of medical records from Jehovah's Witnesses patients (n = 4) who underwent orthotopic liver transplantation from September 2009 to September 2011 at the Walter Cantídio University Hospital of the Federal University of Ceará, Fortaleza, CE, Brazil. Coagulation parameters such as Hemoglobin, Hematocrit, Platelets, INR were evaluated during the preoperative, immediate postoperative, postoperative day (POD) 7 and POD 30. Results Coagulation parameters were expressed as means: hematocrit, 35.07% ± 6.65%, 24.6% ± 4.74%, 19.85% ± 2.10%, 31.85% ± 5.99%; hemoglobin, 12.57 g/dL ± 2.22, 8.92 g/dL ± 1.75, 6.92 g/dL ± 0.58, 11.17 g/dL ± 0.9; platelets, 160,975 mm 3 ± 148000, 128,000 mm 3 ± 34836, 65,000 mm 3 ± 33496, 234,250 mm 3 ± 287003 and INR, 143 ± 0.10, 2.4 ± 0.34, 1.24 ± 0.10, 1.14 ± 0.09. Conclusion Liver transplantation can successfully be performed in Jehovah's Witnesses patient population provided that: 1) the medical team has extensive expertise in that field, 2) the patient has an adequate level of hematologic factors preoperatively, and 3) there is availability of specialized equipment such as cell saver to minimize blood loss and thus avoid transfusion requirements.
publisher Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE.
publishDate 2013
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032013000200138
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