Major liver surgery in a Jehovah’s Witness patient: challenges for safe surgery
| Autor: | Wan Yen Lim, Patrick Wong, Brian Kim Goh, Sim Leng Tien, Leonard Wei Wen Loh, Suneel Ramesh Desai |
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| Rok vydání: | 2019 |
| Předmět: |
Liver surgery
medicine.medical_specialty Blood transfusion business.industry General surgery Jehovah s witness medicine.medical_treatment Beneficence Perioperative 030204 cardiovascular system & hematology Safe surgery 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine 030202 anesthesiology Informed consent medicine General anaesthesia business |
| Zdroj: | Southern African Journal of Anaesthesia and Analgesia. :24-26 |
| ISSN: | 2220-1173 2220-1181 |
| DOI: | 10.36303/sajaa.2019.25.3.2220 |
| Popis: | Jehovah’s Witnesses presenting for major surgery run the risk of major bleeding, which is complicated by the refusal to accept blood transfusion. We present a case of a 63-year-old woman, a Jehovah’s Witness, who was diagnosed with hepatocellular carcinoma and advised for curative laparoscopic liver segmentectomy. Due to the risk of significant intraoperative haemorrhage, her perioperative care was coordinated in a multidisciplinary manner. Informed consent requires the physician to advise on the material risks of undertaking major surgery without blood transfusion and the possible alternatives. Conflicting ethical issues of patient autonomy and beneficence related to refusal of blood products also arise. Perioperative strategies to minimise blood loss, maximise haematopoiesis and tolerance of anaemia to facilitate safe surgery in such patients are also presented. Written patient consent obtained. |
| Databáze: | OpenAIRE |
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