NoBlood

Giving Patients a Choice about Transfusion-Free Surgery


When Derl G. Stallard recently underwent surgery because of nose and sinus cancer, he and his family were able to concentrate on his recovery instead of worrying about violating their religious beliefs.

As Jehovah’s Witnesses, the dentist from Maggie Valley, NC, and his family chose Duke University Hospital (DUH) because the surgery could be performed without using blood products.

“This means a great deal, not only for me and my family, but for literally thousands of those who would appreciate it because of our religious beliefs,� said Stallard. “Jehovah’s Witnesses go anywhere across the country seeking medical attention where we feel there is the skill and the ability to do surgery without blood. We will do whatever it takes because of our beliefs. My family and I have never been treated as well as we have in this institution. Everyone has respected our beliefs, and there has been no problem at all.�

While bloodless healthcare services are primarily requested by people for reasons of faith, others are choosing this health care alternative because of concerns about blood-borne diseases such as Hepatitis C or HIV, personal preferences or other health benefits associated with transfusion-free medicine and surgery.

To help meet those needs, DUH will be among the few tertiary care medical centers in the nation to offer a formal program for the use and advancement of bloodless or transfusion-free surgery beginning Sept. 1 with the opening of the Duke Center for Blood Conservation (CBC).

The center will be comprised of a multi-disciplinary health care team to meet the needs of these patients. The CBC is the result of two years of planning by many faculty, staff and divisions, with the full support of hospital leadership.

“Whether patients refuse blood and blood products for religious or personal reasons, they need medical care that’s committed to their beliefs,� says Pam Pennigar, a nurse practitioner and CBC program manager. “We have a panel of physicians who are dedicated to respecting patients’ wishes regarding blood alternatives and who are experienced in providing a variety of medical and surgical interventions without its use. Additionally, our patient care staff will be trained in bloodless protocols and sensitivities.�

Alternatives to Blood Transfusion
“Whatever the reasons, a growing number of hospital patients nationwide are seeking alternatives to blood transfusion during surgery,� says Steven Hill, M.D., a Duke anesthesiologist who co-directs the CBC with Jeffrey Lawson, M.D., Ph.D., a general and vascular surgeon. “We offer our patients a number of treatment options to eliminate the need for blood transfusions. Involving patients in their health care planning and treatment is a core value at Duke. �

Blood conservation techniques involve optimizing red blood cell production before surgery, as well as using alternative surgical techniques to decrease blood loss during surgery.

“We now have a variety of medications to increase the production of red blood cells, boost blood volume, reduce bleeding and enhance blood clotting,� Hill explains. “Surgical devices, such as a beam coagulator (which clots blood during surgery) and electrocautery (cauterizing behind the incision), also help reduce blood lost during surgery. Hemodilution (a process that involves drawing off, then reinfusing the patient’s own non-stored blood at the end of his or her surgery) is another important clinical strategy within the transfusion-free medicine and surgery program.�

Patients requesting blood conservation services through the CBC will meet individually with members of the care team, including a physician, to discuss the available options. More than 31,000 surgeries are performed at Duke annually.

Simply Good Medicine
The concept of blood conservation and avoiding transfusion is gaining broad appeal not only among patients but also among medical professionals because it is simply good medicine, Pennigar says. Benefits of bloodless surgery include faster recovery times, shorter hospital stays, reduced costs, and better management of the increasingly scarce resource of donated human blood.

“These positive results make the future of bloodless medicine very exciting and promising,� she says. “Numerous specialties at Duke are committed to providing blood conservation or bloodless care to our patients who want them. If patients feel that bloodless surgery is right for them, then our healthcare team is dedicated to honoring their decision.�

For more information about the Duke Blood Conservation Center or to make an appointment, call Pam Pennigar at 668-2467 or long distance at 1-866-500-4515, or call 1-800-ASK DUKE.

Blood Conservation Center Open House
An open house for the new Duke Center for Blood Conservation will be held Nov. 13 from 1 - 4 p.m. in the Searle Center.



Duke Hospital will become one of the first tertiary care medical centers in the Southeast to offer a formal program for the use and advancement of bloodless or transfusion-free surgery when the center opens Sept. 1. For more information about the center or to make an appointment, call Pam Pennigar at 668-2467 or long distance at 1-866-500-4515, or call 1-800-ASK DUKE.

__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email