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Jehovah's Witnesses do not permit the use of allogeneic blood products. An increasing number of patients are refusing blood transfusion for non-religious reasons. In addition, blood stores are decreasing, and costs are increasing. Transfusion avoidance strategies are, therefore, desirable. Bloodless surgery refers to the co-ordinated peri-operative care of patients aiming to avoid blood transfusion, and improve patient outcomes. These principles are likely to gain popularity, and become standard practice for all patients. This review offers a practical approach to the surgical management of Jehovah's Witnesses, and an introduction to the principles of bloodless surgery that can be applied to the management of all patients.

Original publication




Journal article


Ann R Coll Surg Engl

Publication Date





3 - 14


Advance Directives, Blood Loss, Surgical, Blood Transfusion, Hematopoiesis, Hemodilution, Humans, Informed Consent, Intraoperative Care, Jehovah's Witnesses, Surgical Procedures, Operative, Treatment Refusal