Case Report

Successful Use of a Polymerized Hemoglobin Blood Substitute in a Critically Anemic Jehovah's Witness

Authors: Genève Allison, MD, Colin Feeney, MD, FACP

Abstract

A stable, polymerized hemoglobin product has been formulated that overcomes the three traditional hurdles of hemoglobin-based blood substitutes: nephrotoxicity, osmotic diuresis, and blood-borne pathogens. We present a case of a patient with persistent colonic bleeding and a hemoglobin of 2.9 g/100 mL. Since her religious faith prevented her from accepting blood products, we offered a hemoglobin-based substitute and describe the use of this product.


Key Points


* Patients of the Jehovah's Witness faith believe that they risk their immortal soul if they accept blood products.


* The official church position has changed so that they can accept a polymerized hemoglobin blood substitute.


* We describe the appropriate use of this product as a bridge for life-threatening hemorrhage.

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References

1. Cothren C, Moore EE, Offner PJ, et al. Combined blood substitute and erythropoietin therapy in a severely injured Jehovah's Witness. N Engl J Med 2002;346:1097–1098.
 
2. Gannon CJ, Napolitano LM. Severe anemia after gastrointestinal hemorrhage in a Jehovah's Witness: new treatment strategies. Crit Care Med 2002;30:1893–1895.
 
3. Brimacombe J, Skippen P, Talbutt P. Acute anemia to a hemoglobin of 4 g-l with survival. Anaesth Intensive Care 1991;19:581–583.
 
4. Hardy JF, Bélisle S, Van der Linden P. Combined blood substitute and erythropoietin therapy in a severely injured Jehovah's Witness. N Engl J Med 2002;347:696–697.