Coagulopathy After Cardiopulmonary Bypass in Jehovah’s Witness Patients: Management of Two Cases Using Fractionated Components and Factor VIIa

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Abstract

BACKGROUND:

Changes in the Jehovah's Witness (JW) blood refusal policy now give members the personal choice to accept certain processed fractions of blood, such as factor concentrates and cryoprecipitate.

METHODS:

Two JW patients undergoing complex aortic surgery who developed severe microvascular bleeding after prolonged use of cardiopulmonary bypass were treated with recombinant activated factor VII, cryoprecipitate, and antithrombin concentrate.

RESULTS:

Cardiopulmonary bypass-induced coagulopathy was successfully treated, allowing chest closure without evidence of thrombotic complications.

CONCLUSIONS:

Processed blood fractions can be a valuable adjuvant to drugs when treating bleeding in JW patients.

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