Abstrait

Strategic and operational aspects of the Jeovah?s witness patient?s candidates for deceased-donor kidney transplant

Alessandro Bacuzzi, Luca Guzzetti, Valeria Alicino, Giuseppe Rombol

Introduction: The correct perioperative management of Jehovah's Witness candidate for kidney transplant is a complex clinical and organizational effort for the whole team involved, to ensure patient safety, transplanted organ survival and respect for the religious motivation.

Aim: This protocol aims to provide a shared and agreed pathway for the evaluation and management of the Jehovah’s witness patients with end-stage chronic kidney disease, candidates for kidney transplant from cadaveric donor.

Material and Methods: An extensive medical literature search was performed using search engines through keywords like 'Jehovah's witness', 'blood transfusion, 'kidney transplant' and 'blood refusal' to create a pathway for the evaluation and management of the Jehovah's witness patients with end-stage chronic kidney disease, candidate to kidney transplant from cadaveric donor.

Results: We developed a treatment protocol for Jehovah’s Witness patients undergoing kidney transplant in our University Hospital. Surgical suitability is obtained after an accurate preoperative basic evaluation, in addition to cardiology, respiratory and haematological review. Excellent efficacy of rHuEPO associated with iron, vitamin B12 and folate in the treatment of anemia in CKD patients.

Conclusion: The implementation of this specific protocol ensures patient safety with low rate of perioperative complications.