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Is There Sufficient Evidence Justifying Limited Access of Jehovah’s Witness Patients to Kidney Transplantation?
- Source :
- Transplantation. 105:249-254
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Background Jehovah's Witnesses (JWs) refuse blood transfusions due to religious issues. This situation may impact kidney transplantation (KT) outcomes in case of hemorrhagic complications. We evaluated demographic characteristics of this population, hematologic safety, and graft outcomes. Methods This was a retrospective, single-center study comparing KT outcomes in JW patients versus a non-JW control group. Hematologic endpoints included clinical indication for blood transfusion (hemoglobin 2 g/dL or hematocrit >5% in the first week after KT, hemorrhagic complications requiring surgery, and de novo prescription of erythropoiesis-stimulating agents. Secondary endpoints included delayed graft function, treated biopsy-proven acute rejection, renal function, mortality, and graft survival at 12 months. Results From January 1989 to September 2018, we identified 143 JW (10 pediatric) and selected 142 matched control (non-JW) patients. There were no differences in the incidence of clinical indication for transfusion (13.3% versus 11.3%, P = 0.640), but a higher proportion of non-JW patients received transfusions (2.1% versus 9.2%, P = 0.010). There were no differences in the proportion of patients with decreased hemoglobin concentration, in reinterventions due to hemorrhagic complications, in the use of erythropoiesis-stimulating agents at hospital discharge, in the incidence of acute rejection, in renal function, and in mortality or graft survival rate at 12 months. Conclusions In summary, this matched control cohort study suggests that, when clinically indicated, blood transfusions can be safely avoided in the majority of JW kidney transplant, who achieve and maintain comparable hemoglobin concentrations during the first year after transplantation compared with non-JW patients.
- Subjects :
- Adult
Graft Rejection
Male
Health Knowledge, Attitudes, Practice
medicine.medical_specialty
Time Factors
Blood transfusion
medicine.medical_treatment
Population
Renal function
Postoperative Hemorrhage
030230 surgery
Hematocrit
Risk Assessment
Health Services Accessibility
Treatment Refusal
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Blood Transfusion
education
Jehovah's Witnesses
Kidney transplantation
Retrospective Studies
Transplantation
education.field_of_study
medicine.diagnostic_test
business.industry
Incidence (epidemiology)
Graft Survival
Religion and Medicine
Middle Aged
medicine.disease
Kidney Transplantation
Treatment Outcome
Hematinics
Female
030211 gastroenterology & hepatology
business
Cohort study
Subjects
Details
- ISSN :
- 00411337
- Volume :
- 105
- Database :
- OpenAIRE
- Journal :
- Transplantation
- Accession number :
- edsair.doi.dedup.....ae595d2e510d7b3d99d19a92d688373e