Challenges of dialyzing a bleeding, anaemic Jehovah’s Witnesses patient without blood transfusion

Abstract

Background: Hemodialysis is the prescribed treatment for uremia and is life-saving. Most centers, including the University of Benin Teaching  Hospital require that patienthas minimum of hemoglobin 6.7g/dl (PCV 20%) before hemodialysis. Patient had been refused dialysis at 2 different centers.
Aim: We present this Jehovah’s Witnesses patient that was bleeding postprostatectomy, with PCV 16% (Hb 5.3 mg/dl), in uraemic encephalopathy and hypotensive. Patient and all his relatives refused blood transfusion on account of being of the Jehovah’s Witnesses faith. Patient presented at Yeshua Medical center, with Urea 246mg/dl, Creatinine 13.1 mg/dl and blood pressure 80/50mmHg.
Materials and Method: Relatives of patient were cautioned on the need for blood transfusion. They provided signed waivers in case of any outcome considering the very poor prognosis. Patient was dialyzed with Nikkisso DBB 05/06 without systemic heparinisation.
Results: The patient improved significantly after first session of dialysis and had complete recovery after subsequent 2 sessions.
Conclusion: Dialyzing anemic bleeding patients appearstobe feasible in those who refuse blood transfusion on account of religious inclination, so  long as adequate safety procedures are followed.

Key Words: Anemia, Bleeding, Dialysis, Blood Transfusion, Jehovah’s Witness