Hemodynamics, fluids & transfusion
Preoperative Blood Augmentation in Jehovah’s Witness Patients Undergoing Transfusion-Free Surgery for Gastrointestinal or Hepato-biliary-pancreatic Cancer: Retrospective Cohort Study
Authors' conclusion
Proactive blood augmentation in patients with preoperative anemia enables safe and effective transfusion-free cancer surgery without delaying the indicated procedure.
Study context
- Population
- Jehovah's Witness patients undergoing transfusion-free surgery for gastrointestinal or hepato-biliary-pancreatic cancer, Shonan Atsugi Hospital, January 2017–December 2020125 registered
- Participants
- 100 patients
- Exposure
- Anemic vs Non-anemic
- Anemicn = 44
- Non-anemicn = 56reference
- Outcome
- Postoperative mortality and complications (Clavien-Dindo grade >IIIa)
- Follow-up
- 30 days
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Secondary outcomes
Waiting time to surgery (blood augmentation period in the anemic group) · did not differ significantly
P = 0.13
Postoperative Hb · POD 7
- Postoperative hemoglobin (Hb) — Perioperative Hb levels showed significant time-by-intervention interactions
- P <.001
- Hb in the anemic group, baseline to preoperative: Anemic (baseline) mean 10.8 (SD 2.0) g/dL
- Hb in the anemic group, baseline to preoperative: Anemic (preoperative) mean 11.5 (SD 1.2) g/dL
- Postoperative Hb: recovered to levels comparable to the non-anemic group by POD 7
Safety
Severe complications (Clavien-Dindo grade >IIIa) and 30-day mortality
- Did not differ between the anemic and non-anemic groups (primary outcomes; see key findings)
Original publication
Preoperative Blood Augmentation in Jehovah’s Witness Patients Undergoing Transfusion-Free Surgery for Gastrointestinal or Hepato-biliary-pancreatic Cancer: Retrospective Cohort Study. Anesth Analg. Published 16 June 2026. doi:10.
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