Alternatives to blood transfusions used in liver transplantation in Jehovah’s Witnesses: an integrative review
DOI:
https://doi.org/10.11606/issn.1679-9836.v102i4e-205575Keywords:
Liver Transplantation, Jehovah's Witnesses, Bloodless Medical and Surgical Procedures, Blood TransfusionAbstract
Introduction: Liver transplantation (LTx) is a surgical intervention with the possibility of variable bleeding, in which the transfusion of blood components or whole blood may be necessary. However, Jehovah's Witnesses (JW) patients are known not to accept transfusions of blood or heterologous blood components, requiring the use of a differentiated management and use of hemostatic therapies. Methods: Articles were selected from the PubMed database from 1991 to November 2022 with the descriptors “Liver Transplantation in Jehovah's Witnesses”. After careful reading, 16 articles were selected for this review. Results: preoperative hemostatic therapies (erythropoietin, folic acid, iron), intraoperative (piggyback technique, acute normovolemic hemodilution, Cell saver) and postoperative (maintenance of erythropoiesis-stimulating therapies) were identified. Conclusion: Considering the important role of transfusion and hemostatic therapies in LTx and the need for alternatives for TJ patients, this study identified the most used techniques in these patients and demonstrated the individual benefits of each one.
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