I have been asked if cell tagging usually involves a long time delay and/or removal of the blood from the room to another location, maybe even another building for mixing with a radioisotope before reinjecting in the patient or is everything done there and then beside the patient's bed? Can anyone comment, please?

You should check with the radiology department of the institution where you are for the exact procedure there. I can tell you that one place I have worked, the blood is removed from the patient, taken across the hallway to the mixing room, once the radioisotope is added to the blood, it is mixed for several minutes before being injected back into the patient. The point being not that there is a long delay before re-injecting or even that it is completely removed (no continuous circuit) but that this is a diagnostic procedure to determine where internal bleeding might be. It is not a transfusion. Those with religious concerns can read the 10/15/2000 Watchtower Questions for Readers. That answer specifically describes blood tagging and lists it along with many other procedures under the individual conscientious choice category.
Jo

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Jo Valenti, RN
CBMS
Kennedy Health System

There are two different kinds of cell tagging. With red cell tagging they generally take about 3/4 teaspoon (3cc) blood to tag it, and the tagged blood is returned to the patient in about 15-20 minutes. BUT I understand there is a very expensive alternative to extracorporeal tagging. My very basic understanding is that they can first inject the patient with PyroPhosphate (Cis-Pro, PYP), which is a chemical that allows the red cells to accept the tagging in vivo, then they inject the radioisotopes. Everyone should be able to accept this process without a problem for their conscience provided there is no other contraindication to using this chemical. For white cell tagging, about 3 ounces of blood is withdrawn. The white cells are separated from the rest of the blood in a pharmaceutical laboratory. (My understanding is that most hospital laboratories cannot do this separation.) Radioisotopes are then attached to the patient's white cells. In our facility this means the white cells are out of the patient for about four hours, despite not being stored on either end, and close proximity of a lab that can do this procedure. While the October 15, 2000 Watchtower 'Questions from Readers" specifically addresses tagging as a conscience matter, my experience is that some Witnesses will accept all tagging, others will accept red cell tagging done the conventional way, and some won't accept any type of tagging. It's just like anything else. People have to do what they are comfortable with, and we have to explain the details of each alternative so they can make an educated decision.

This discussion contains the same vital elements as the blood patch. The issue that needs to be distinguished on an individual basis is; Does the person have the most update information regarding the use of these procedures from a religious standpoint? The Watchtower Society does not qualify the use the of these procedures through the use of restrictions such as a "continuous or closed circuit". Once it has been established an indivdual is accurately informed from a religious viewpoint then this becomes an individual conscience matter.

Are procedures being altered in response to a lack of accurate information?