Liver transplantation in Jehovah’s Witness patients in Australasia

Gary P Jeffrey, John McCall, Edward Gane, Andrew W Mitchell, Neville M Gibbs, Vanessa Beavis, Kerry Gunn, Stephen Munn and Anthony K House
Med J Aust 2007; 187 (3): 188-189.

Until recently, liver transplantation was contraindicated in Jehovah’s Witness patients because of recipient-imposed restrictions on use of blood products. However, recent improvements in surgical and anaesthetic techniques and new procoagulant agents challenge this practice. We describe two Jehovah’s Witness patients who had successful liver transplantation without blood transfusion. To our knowledge, these are the first such cases in Australasia. The techniques used to minimise blood loss and transfusion requirements could potentially benefit all patients undergoing major surgery.

A 48-year-old farmer with end-stage cirrhosis due to α-1 antitrypsin deficiency had evidence of moderate portal hypertension with splenomegaly and ascites (Child–Pugh score B), but no significant lung disease. He met minimum recipient suitability criteria for liver transplantation, according to the Transplantation Society of Australia and New Zealand (TSANZ) liver standing committee.1 As a Jehovah’s Witness, he would not accept transfusion of red blood cells, fresh frozen plasma or platelets.

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  • Gary P Jeffrey1,2
  • John McCall3
  • Edward Gane3
  • Andrew W Mitchell1
  • Neville M Gibbs1
  • Vanessa Beavis3
  • Kerry Gunn3
  • Stephen Munn3
  • Anthony K House1

  • 1 Western Australian Liver Transplantation Service, Sir Charles Gairdner Hospital, Perth, WA.
  • 2 School of Medicine and Pharmacology, The University of Western Australia, Perth, WA.
  • 3 The New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand.

Competing interests:

None identified.

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