Work

Bypass surgery in a Jehovah’s Witness with critical limb ischemia and end stage renal disease: a case report

Year: 2025

Type: article

Abstract: A 60-year-old female Jehovah's Witness with critical limb ischemia and end-stage renal disease underwent staged revascularization including endovascular intervention, free flap reconstruction, and ultimately femoropopliteal bypass using in situ great saphenous vein. Despite maximal blood conservation strategies-erythropoiesis-stimulating agents, intravenous iron, and albumin-her postoperative hemoglobin dropped to 4.7 g/dl without any evidence of active bleeding. She declined allogeneic transfusion and developed multiorgan failure, resulting in death on postoperative Day 3. This case highlights the clinical and ethical complexities of managing high-risk vascular patients who refuse blood transfusion, emphasizing the need for individualized risk assessment, careful perioperative planning, and consideration of patient autonomy under potential external influence.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf795

Author: Eol Choi

Institutions: Soonchunhyang University, Soonchunhyang University Hospital Bucheon

Language: English

Topic: Blood transfusion and management

Subfield: Biochemistry

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000