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EPV174/#144 Perioperative blood management of Jehovah’s witnesses undergoing cytoreductive surgery for advanced ovarian cancer
  1. I Palaia1,
  2. G Caruso1,
  3. V Di Donato1,
  4. G Perniola1,
  5. G Ferrazza2,
  6. E Panzini2,
  7. M Scudo1,
  8. R Gallo1,
  9. L Muzii3 and
  10. P Benedetti Panici1
  1. 1Sapienza University of Rome, Department of Maternal and Child Health and Urological Sciences, Rome, Italy
  2. 2Sapienza University of Rome, Department of Immunohematology and Transfusion Medicine, Rome, Italy
  3. 3Sapienza University, Gynecologic Oncology, Rome, Italy


Objectives This study aimed to evaluate the efficacy and feasibility of a perioperative Bloodless Medicine and Surgery (BMS) protocol in reducing severe postoperative anemia (Hb <7 g/dL) in Jehovah’s Witnesses (JWs) undergoing cytoreductive surgery for advanced epithelial ovarian cancer (AEOC).

Methods This was a single-institution retrospective study enrolling JWs who underwent elective bloodless surgery for AEOC between October 2017 and April 2020. All patients followed a standardized BMS protocol based on ferric carboxymaltose (FCM) and erythropoietin (EPO) if indicated.

Results Twenty-five patients with a mean age of 61.7 years (range, 35–80) were enrolled. Preoperatively, 10 patients (40%) were mildly anemic (mean Hb of 10.2 g/dL [range, 9.2–11.4]) and received FCM. Only 4 (16%) patients had severe anemia after surgery (mean Hb of 6.1 g/dL [range, 4.1–6.9]) and received FCM and EPO. Compared to patients with postoperative Hb >7 g/dL, those with Hb <7 g/dL reported higher mean BMI (25.8±1.8 vs 30.7±1.8 kg/m2; p<0.001), mean baseline CA125 (236.1±184.5 vs 783.7±273.5 IU/mL; p<0.001), median surgical complexity score (2 vs 10; p<0.001), and postoperative overall complications (100% vs 14.3%; p<0.001). Moreover, these patients showed longer mean operating time (3.4±0.6 vs 5.5±0.4 h; p<0.001), hospital length of stay (5.5±0.7 vs 24.0±9.8 days; p<0.001), and time to adjuvant chemotherapy (27.2±2.6 vs 65.3±13.4 days; p<0.001).

Conclusions The use of a multidisciplinary BMS protocol is safe and effective in reducing the rate of severe postoperative anemia and improving surgical and oncological outcomes of JWs with AEOC. Further large-scale, prospective studies are required to confirm these data.

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