Bloodless Alternative To Transfusion For Jehovah's Witnesses And Transfusion-Wary

Main Category: Blood / Hematology
Also Included In: Public Health
Article Date: 06 Dec 2007 - 6:00 PDT

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"Jehovah's Witness patients no longer have to die for want of blood," says Patricia Ford, MD, a hematologist/oncologist and Medical Director of the Center for Bloodless Medicine and Surgery at Pennsylvania Hospital, part of the PENN Medicine hospital network. Dr. Ford is one of the pioneers of bloodless surgery and has been teaching its technique to doctor's around the world.

One technique a bloodless surgery can employ is called "cell salvage" in which blood lost during surgery is siphoned from the body, passed through a filter for cleaning and returned to the body. It can also be used by the physician during surgery to limit blood loss and to avoid the need for transfusion of blood from sources other than the patient.

Jehovah's Witness patients believe that accepting blood from a source other then themselves defies the scriptural teachings that their religion holds steadfast. Originally developed to meet the needs of the Jehovah's Witness community, bloodless surgery is transfusion-free and is acceptable to Jehovah Witness followers because they are being reinfused with their own blood. Bloodless surgery and medicine is a viable and life-saving option for these patients and those wary of the safety of the blood supply, and it is safe for a growing number of surgical and medical conditions, except for acute leukemia and traumatic injury.

"Bloodless procedures have proven to be safer than blood transfusion because they help eliminate complications resulting from transfusions such as immunosuppression, infection, diseases from emerging pathogens for which our blood supply is not yet tested," said Dr. Ford. "The hospital stay is also shorter for our bloodless patients, a cost savings for the patient and the institution," she continues. Pennsylvania Hospital in Philadelphia is one of the pioneering centers for bloodless medicine and surgery.

Dr. Ford likens the weeks-old blood often used for transfusions to "water from a dirty fish tank." Depleted of most of its oxygen-carrying capacity, the stored blood is not maximally beneficial to any patient.

Prior to surgery, Dr. Ford prepares patients carefully - using medicines to build red blood cells, and managing their hemoglobin count. A higher hemoglobin level lowers the risk of transfusion.

Dr. Ford has performed the largest number of successful stem cell transplants without blood transfusion of anyone in the world. Among the procedures for which Dr. Ford has prepared patients for bloodless medicine and surgery are cardiothoracic surgery; radical hysterectomies, prostatectomies, cystectomies, and repair of aneurysms, chemotherapy management, and total hip and knee surgery.

The bloodless team at Pennsylvania Hospital has saved the lives of many Jehovah's Witness patients who otherwise would not have received care. "We see patients from all over the country who come to us for our expertise in bloodless medicine. The needs of the Jehovah's Witness community have helped us develop practices that can not only save their lives, but can also benefit the entire patient community," explained Dr. Ford.

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About Pennsylvania Hospital

Pennsylvania Hospital -- the nation's first -- was founded in 1751 by Benjamin Franklin and Dr. Thomas Bond. Today, the 515-bed acute care facility offers a full-range of diagnostic and therapeutic medical services and is a major teaching and clinical research institution. The hospital has over 25,000 admissions each year, including over 5,000 births. With a national reputation in areas such as orthopaedics, cardiac care, vascular surgery, neurosurgery, otorhinolaryngology (ENT) and urology as well as obstetrics, high-risk maternal and fetal services, neonatology, and behavioral health, the campus also includes specialty treatment centers such as the Joan Karnell Cancer Center, the Center for Bloodless Medicine and Surgery, the PENN Neurological Institute and the radiosurgical Gamma Knife Center. Pennsylvania Hospital is part of the University of Pennsylvania Health System and is located in the historic Society Hill district of Philadelphia.

Source: Lee-Ann Landis
University of Pennsylvania School of Medicine

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