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Use of cell salvage and HBOC-201 in a pregnant Jehovah’s Witness with sickle beta+thalassaemia undergoing emergency caesarean section
  1. Julia Fortier1,
  2. Shiyi Pang2,
  3. Soleil Schutte3,
  4. Marc Stuart Zumberg2 and
  5. Anita Rajasekhar2
  1. 1College of Medicine, University of Florida, Gainesville, Florida, USA
  2. 2Department of Medicine, Division of Hematology/Oncology, University of Florida, Gainesville, FL, USA
  3. 3Department of Anesthesiology, University of Florida, Gainesville, FL, USA
  1. Correspondence to Dr Anita Rajasekhar; anita.rajasekhar{at}


Patients with severe anaemia who refuse or cannot safely receive red cell transfusion present challenges during pregnancy, delivery and the postpartum period. Strategies including HBOC-201 (Hemopure) and intraoperative use of cell salvage have been used in non-pregnant patients to improve oxygen carrying capacity; however, these products pose unique risks in pregnant patients, those with sickle cell disease (SCD) and those undergoing caesarean section (C-section). We describe a case of a pregnant sickle beta+thalasasaemia patient who presented at 27 weeks gestation with pre-eclampsia and severe anaemia. As a Jehovah’s Witness, she declined allogenic blood transfusion. The patient successfully underwent emergent C-section with cell salvage and received HBOC-201 immediately after delivery, during the operative procedure. To our knowledge, this is the first published report documenting a Jehovah’s Witness patient with SCD who successfully received cell salvage and then HBOC-201 immediately postdelivery.

  • Haematology (drugs and medicines)
  • Haematology (incl blood transfusion)
  • Pregnancy

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  • Contributors JF put together a draft of the report and made the figure and table. SP, AR and MSZ were involved in the patient’s haematological care and contributed details/wrote sections related to the use of Hemopure in this patient. SS performed the anesthesia for the C-section, and provided details/wrote sections related to the use of cell salvage in this patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.