{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:46:36Z","timestamp":1760060796004,"version":"build-2065373602"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 60-year-old female Jehovah\u2019s Witness with critical limb ischemia and end-stage renal disease underwent staged revascularization including endovascular intervention, free flap reconstruction, and ultimately femoropopliteal bypass using in situ great saphenous vein. Despite maximal blood conservation strategies\u2014erythropoiesis-stimulating agents, intravenous iron, and albumin\u2014her postoperative hemoglobin dropped to 4.7\u00a0g\/dl without any evidence of active bleeding. She declined allogeneic transfusion and developed multiorgan failure, resulting in death on postoperative Day 3. This case highlights the clinical and ethical complexities of managing high-risk vascular patients who refuse blood transfusion, emphasizing the need for individualized risk assessment, careful perioperative planning, and consideration of patient autonomy under potential external influence.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf795","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:51:28Z","timestamp":1760035888000},"source":"Crossref","is-referenced-by-count":0,"title":["Bypass surgery in a Jehovah\u2019s Witness with critical limb ischemia and end stage renal disease: a case report"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0576-9524","authenticated-orcid":false,"given":"Eol","family":"Choi","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, Department of Surgery, Soonchunhyang University College of Medicine and Soonchunhyang University Bucheon Hospital , 170, Jomaru-ro, Bucheon-si, Gyeonggi-do 14584 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"2025100914512362100_ref1","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1016\/j.jvs.2006.12.037","article-title":"Inter-society consensus for the management of peripheral arterial disease (TASC II)","volume":"45","author":"Norgren","year":"2007","journal-title":"J Vasc Surg"},{"key":"2025100914512362100_ref2","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1016\/S0140-6736(05)67704-5","article-title":"Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial","volume":"366","author":"Adam","year":"2005","journal-title":"Lancet"},{"key":"2025100914512362100_ref3","doi-asserted-by":"crossref","first-page":"57S","DOI":"10.1592\/phco.27.9part2.57S","article-title":"Update on transfusion 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