“Cardiac Operation for Congenital Heart Disease in Children of Jehovah’s Witnesses”
Under the above title, The Journal of Thoracic and Cardiovascular Surgery, Volume 89, 1985, published the results of heart operations performed on 110 children of Jehovah’s Witnesses. It stated: “No patient received any blood or blood products during hospitalization.” The patients ranged in age from 6 months to 12 years. Although complications occurred in ten patients, “none of these could be attributed to failure to transfuse.”
Then why are some surgeons reluctant to operate on children without the use of blood? The article states: “One concern in children is that the volume of crystalloid required to prime the extracorporeal circuit [heart-lung machine] would result in a degree of hemodilution [blood dilution] incompatible with adequate oxygen delivery. Another is that blood loss from operation and the coagulopathies [blood-clotting problems] associated with congenital heart disease could not be managed successfully without blood components.”
However, in these cases with Witness children, how was the heart-lung bypass machine primed without blood? The circuit was primed with a crystalloid solution, using at first dextrose in water and then in later operations dextrose in Ringer’s lactate. Blood was not necessary.
What were the findings from these operations on Witness children? “The results demonstrate that excessive hemodilution and postoperative hemorrhage are not major problems, even in small patients, and that failure to transfuse is rarely a factor in the morbidity or mortality of operation.”—Italics ours.
Of course, small children start off with a lower blood volume, which means a higher rate of dilution when the bypass machine primed with crystalloid is used. In spite of that, during the operation and the first 24 hours thereafter, “the smaller patients . . . lost no greater percentage of their total hemoglobin than the larger patients.”
Were the surgeons satisfied with the overall outcome of these operations? “The results were not compared with those in children freely transfused to support our impression that children of Jehovah’s Witnesses usually do as well or better. Nevertheless, the low morbidity and mortality we observed raises the question of whether similar techniques of hemodilution and blood conservation might be used more extensively in children undergoing cardiac operations.”
To what conclusion did the Houston, Texas, team of surgeons arrive? “Our results demonstrate that cardiac operations and cardiopulmonary bypass can be safely performed in children without blood transfusion.”
There are inherent dangers in blood transfusion, such as the risk of transmitting hepatitis, syphilis, and AIDS. The thousands of cases involving Jehovah’s Witnesses worldwide who have been treated over the last few decades establish that there is a sound basis for alternative bloodless therapy that avoids such complications.