NoBlood

Jan B. Wade · #1 (**permalink**) 06-01-2005, 05:41 AM

http://www.suntimes.com/output/healt...s-blood01.html

More hospitals offer 'bloodless surgery'

June 1, 2005

BY JIM RITTER Health Reporter

Mary Sipiora's doctor told her she needed a heart valve replacement, an operation that normally requires four or five units of donated blood. But Sipiora, a Jehovah's Witness, does not believe in blood transfusions. "God's word says to abstain from blood," she said. So Sipiora had her operation at Swedish Covenant Hospital, the second hospital in Chicago to offer "bloodless surgery." So far, most patients have been Jehovah's Witnesses, but the hospital is offering bloodless surgery to anyone who's uncomfortable with donated blood.

"The public has been educated to think transfusions are the solution to everything. That isn't always the case," said Jan Graziani, Swedish Covenant's blood conservation In 1987, Our Lady of the Resurrection Medical Center helped pioneer bloodless medicine. Today, between 125 and 200 hospitals offer bloodless surgeries, the Society for the Advancement of Blood Management said.

Blood supplies 'critically low'

Some techniques that reduce or eliminate need for transfusions:

*A few weeks before surgery, the patient takes iron, a hormone and vitamins to boost red blood cells.

*About three units of the patient's blood are drained and replaced with a saline solution. After surgery, the blood is returned to the patient.

*When the patient bleeds during surgery, the blood is sucked up, cleaned and returned.

Bloodless surgery is at least as safe as surgeries that use transfusions, said Dr. Aryeh Shander of Englewood Hospital and Medical Center in Englewood, N.J. He said less than 10 percent of Englewood's heart bypass surgeries use transfusions, compared with 30 percent to 70 percent at other hospitals. Englewood still has the lowest risk-adjusted mortality rate in New Jersey, Shander said.

More surgeons are using minimally invasive techniques that require less blood. But overall blood use is increasing, in part because more cancer patients need transfusions to counter effects of chemotherapy, said Dr. Merlyn Sayers of America's Blood Centers.

Sayers said the blood supply is safer than ever. Each unit undergoes 11 highly accurate tests for infectious diseases, including HIV, hepatitis C, West Nile virus and syphilis.

But transfusions are not 100 percent safe. For example, there's a small chance a patient could receive the wrong blood type, which could be fatal. Moreover, periodic blood shortages force hospitals to postpone elective surgeries.

Current supplies are "critically low" according to LifeSource, which supplies blood to most local hospitals. To donate, call (877) 543-3768.

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BLOOD TRANSFUSIONS*

Aplastic anemia: 4 units per month
Auto accident or gunshot wound: 50 units
Bleeding ulcer: 30 units
Bone marrow transplant: 2 units a day for 2 weeks
Brain surgery: 10 units
Cancer: 8 units a week
Cardiovascular surgery: 25 units
Coronary artery bypass: 5 units
Hip replacement: 5 units
Liver transplant: 20 units
Other organ transplants: 10 units
Sickle cell anemia: 4 units a month

*Maximum average usage. One unit equals roughly one pint.
SOURCE: America's Blood Centers
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