Abstract

There are an increasing number of patients who are refusing blood transfusions for several reasons, the most widespread among them being Jehovah’s Witnesses. We present a case of a 66-year-old woman admited to the hospital with gangrene as a complication of the diabetic foot. The hemoglobin level was 4.8g/dl, hematocrit was 15.8% and mean corpuscular volume was 77.1 fL. She needed urgent surgery to amputate her foot. Being one of Jehovah’s Witnesses, she refused blood transfusions. A multimodal blood management approach was applied, and the patient underwent leg amputation without transfusion of any blood product. The treatment strategy is discussed.

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