Affiliations: Department of Anesthesiology and Intensive Care, G B
Pant Hospital, New Delhi, India | Department of Neurosurgery, G B Pant Hospital, New
Delhi, India
Note: [] Correspondence: Dr. Pragati Ganjoo, Department of
Anaesthesiology and Intensive Care, 6th Floor, Academic Block, G B Pant
Hospital, New Delhi 110002, India. Tel.: +91 011 23234242, ext. 5620; Fax: +91
011 23232877; E-mail: pganjoo@gmail.com
Abstract: Jehovah's Witness (JW) is a religious Christian group whose members
believe blood transfusion to be unholy and do not accept blood or its
components, even if refusal of transfusion may prove to be life threatening.
This belief is extended by them to their offspring too, despite the children
being unaware of the implications of their parents' stand. A conflict arises
between the parents' firm position against transfusion and the responsibility
of the treating doctors towards the safety of these children. It raises several
ethical and medico-legal issues, besides requiring a modified treatment plan.
While there are well-defined practice guidelines and legal directives on this
subject in the west, there is a paucity of similar literature in many other
countries including India leading to major transfusion related conflicts. The
perioperative protocol for the surgical management of a JW patient is directed
towards achieving bloodless surgery. An anemic child of JW parents underwent
excision of an intracranial third ventricular mass without blood transfusion at
our hospital. We present here our experience in managing this case using
blood-saving surgical and anesthetic methods including a meticulous surgical
technique and acute hypervolemic hemodilution.
Keywords: Child of Jehovah's Witness parents, neurosurgery, bloodless surgery, transfusion alternative strategies
