Coronary Artery Bypass Grafting (CABG) in Jehovah’s Witness (JW) patients raises concerns regarding perioperative safety because of refusal of allogeneic blood transfusions. This study evaluated the feasibility and short-term outcomes of CABG in JW patients and described perioperative blood management practices. This retrospective observational study included 26 JW patients and 78 matched non-Jehovah’s Witness (non-JW) patients who underwent CABG at InCor HC-FMUSP between 2015 and 2023. Propensity score matching at a 3:1 ratio based on age, sex, and preoperative hemoglobin was used to improve comparability. The primary outcome was 30-day all-cause mortality. Secondary outcomes included 30-day stroke, myocardial infarction, and acute kidney injury; ICU length of stay; perioperative red blood cell transfusion rates; postoperative hemoglobin and hematocrit; intraoperative blood loss; and cardiopulmonary bypass time. No 30-day deaths occurred among JW patients, whereas three deaths occurred in the non-JW group (OR = 0.45; 95% CI 0.003–5.09; p = 0.575). No JW patient experienced stroke, and one myocardial infarction occurred. JW patients had higher postoperative hemoglobin (OR = 1.50; 95% CI 1.03–2.28; p = 0.032) and lower intraoperative blood loss (OR = 0.55; 95% CI 0.27–0.98; p = 0.046). No JW patient received transfusion, whereas 17.9% and 12.8% of non-JW patients required intraoperative and postoperative transfusions, respectively. ICU length of stay was similar between groups. In this cohort, CABG in JW patients was feasible with acceptable short-term outcomes. Outcomes were generally comparable between groups, acknowledging imprecision related to the small JW sample.
Nakano et al. (Fri,) studied this question.