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Eur J Cardiothorac Surg 2006;30:408-410
© 2006 Elsevier Science NL

Case report

Isolated limb perfusion for an irresectable melanoma recurrence in a Jehovah's witness

^a Erasmus University Medical Center—Daniel den Hoed Cancer Center, Department of Surgical Oncology, Rotterdam, The Netherlands
^b Erasmus University Medical Center, Department of Thoracic Surgery—Extracorporeal Circulation, Rotterdam, The Netherlands

Received 8 March 2006; received in revised form 11 April 2006; accepted 11 April 2006.

^_* Corresponding author. Address: Department of Surgical Oncology, Erasmus University Medical Center—Daniel den Hoed Cancer Center, 301 Groene Hilledijk, 3075 EA, Rotterdam, The Netherlands. Tel.: +31 10 4391506; fax: +31 10 4391011. (Email: a.m.m.eggermont{at}erasmusmc.nl).

Isolated limb perfusion (ILP) is a treatment option for irresectable melanoma lesions, because with ILP 20-fold higher concentrations of chemotherapy can be achieved locally than is systemically possible and high response rates are subsequently achieved. Jehovah's witnesses do not accept any form of blood transfusion, either autologous or homologous blood or only blood products. The use of an extracorporeal circuit, without the use of any blood products is acceptable for Jehovah's witnesses. The case of a 59-year-old Jehovah's witness with an irresectable melanoma recurrence for which an ILP. Because of adequate blood flow through the perfused limb, the limb did not become acidotic, even though there was a significant drop in the Hb concentration in the limb during the ILP. Isolated limb perfusions without the use of any blood transfusion products are technically possible, but an adequate preoperative hemoglobin concentration is a prerequisite.

Key Words: Extracorporeal circulation • Melanoma • Isolated limb perfusion • Surgery • Jehovah's witness