Cardiopulmonary bypass in Jehovah's Witnesses

Jehovah's Witnesses do not accept heterologous blood transfusion for religious reasons. Autologous transfusions are also rejected if there is no continuous contact between the circulation and the autologous blood. There is, therefore, the need to adopt methods which will avoid transfusion of heterologous blood in elective cases as far as Jehovah's Witnesses are concerned. We report two cases where pre-operatively administration of nutritional supplements, haematenics, erythropoietin, antimalarials and the modification of the extra-corporeal circulation bypass circuit allowed successful open-heart surgery using cardiopulmonary bypass.