エホバの証人患者に施行した人工関節置換術の2例 —インフォームドコンセントを中心に—

抄録

Jehovah’s witness patients’renunciation to blood infusion is well known worldwide. We performed total hip arthroplasty for two Jehovah’s witness patients with the use of autotransfusion system cell saver without saving the autologous blood.
The first patient was a 47-year-old woman who had been treated for Rheumatoid Arthritis (RA) and right hip pain from May 2003. The patient refused Total Hip Arthroplasty (THA) in several hospitals due to the use of allogeneic transfusion and saving autologous transfusion. In February 2004, she underwent THA. Hypotensive anesthesia and perioperative autotransfusion using cell saver were used.
The second patient was a 51-year-old woman who had been treated for RA and right knee pain from April 2002. She underwent Total Knee Arthroplasty (TKA) with only postoperative autotransfusion using cell saver.
Preoperative informed consent to Jehovah’s Witness patients is very important because of their refusal of blood transfusions while still desiring medical treatment. A clear and satisfactory preoperative informed consent was provided to both patients and relatives.