| Keywords [eng] |
Jehovah’s Witness, blood transfusion refusal, Patient Blood Management, perioperative care, blood conservation, advance directives Jehovos liudytojai, atsisakymas nuo kraujo perpylimo, paciento kraujo valdymas, perioperacinė priežiūra, kraujo taupymas, išankstiniai nurodymai |
| Abstract [eng] |
Jehovah’s Witness patients present a distinct challenge in perioperative medicine due to refusal of allogeneic blood transfusion on religious grounds. Their management requires the integration of ethical, legal, and clinical considerations alongside structured blood conservation strategies. This thesis reviews anaesthetic considerations in this population, focusing on evidence-based perioperative blood management across the preoperative, intraoperative, and postoperative phases. A narrative literature review was conducted using PubMed, ScienceDirect, and Google Scholar, supplemented by clinical guidelines and expert resources. The review examined hemoglobin optimisation strategies, intraoperative blood-sparing techniques, pharmacological interventions, emerging therapies such as artificial oxygen carriers, and the ethical and legal framework surrounding informed consent and advance directives. The findings indicate that a multimodal, patient-centred approach based on Patient Blood Management principles can enable safe surgical care without allogeneic transfusion, with outcomes comparable to standard transfusion-based strategies. Preoperative anemia optimisation, intraoperative conservation techniques, and structured postoperative management are associated with reduced complications. However, limitations persist in emergency surgical settings, variability in patient-specific treatment acceptance, and limited evidence supporting novel therapies, particularly hemoglobin-based oxygen carriers. In conclusion, effective management of Jehovah’s Witness patients requires coordinated integration of clinical optimisation with ethical and legal principles. Individualised planning, clear communication, and multidisciplinary collaborations are essential to balancing patient autonomy with optimal perioperative outcomes. |
