Emergency portacaval shunting in Jehovah's Witnesses.

Major surgical procedures in Jehovah's Witnesses are complicated by their refusal to accept blood transfusion. This problem is accentuated in Jehovah's Witnesses with major gastrointestinal bleeding. The authors present two cases of successful surgical management of upper gastrointestinal bleeding in Jehovah's Witnesses who had bleeding esophageal varices. A short "skin to skin" time and minimal blood loss were important factors in the successful outcome. Treatment of these patients without blood transfusion suggests that less blood might be needed in more routine surgical procedures.