Use of Bloodless Surgery Continues to Grow

Bloodless medicine and surgery was first developed in the 1960s when Dr. Denton Cooley, a pioneering American heart surgeon who graduated from the University of Texas, first successfully performed “bloodless” heart surgery in 1962. [11] He continued his work with bloodless surgery, performing intricate heart operations and vascular surgery without blood on both adults and children. He felt that the risks involved in surgery without blood were no greater than the risks with blood, at that time. [2]

The history of blood transfusions as a general practice in the field of medicine goes back to World War II. However, there have always been risks associated with blood transfusions. [10] Some of those risks include the spread of diseases such as Hepatitis C and AIDS, both of which can be deadly. [9,10] The mortality rate for those who contract Hepatitis C is 11-37% higher for those who have the disease, and the risk of contracting the disease from a blood transfusion in the United States is approximately 1 in 900. [10] This could mean as many as 900 deaths a year attributed to contaminated blood through Hepatitis C. So while the U.S. remains one of the safest countries in the world in terms of its blood supply, there still remains a high risk of contracting various diseases through a blood transfusion.

Additionally, the mortality rate and risk of infection or complications for operations without blood transfusion is much lower than for the same operations with blood transfusions. Some of the statistics indicate,

* Blood transfusions double the risk of heart infection in bypass surgery. [4]

* Heart bypass patients 3 times more likely to die within one month of surgery [5]

* Heart patients twice as likely to die in first month. [5]

* 1996-2003 - Patients 3x more likely to die within one year of blood transfusion with surgery. [5]

* Patients with blood transfusions 6x more likely to die in first month after blood transfusion. [9]

With this in mind, bloodless medicine since the time of Dr. Cooley has made considerable advances, to the point that the non-profit professional organization No Blood, lists at least 30 major non-blood surgery centers in the United States, which meet high standards of quality, five of those centers are located in New Jersey alone. [6]The field is being expanded internationally as well, with major bloodless medical centers in such diverse places as Hong Kong, South Africa, Canada, and Saudi Arabia, Mumbai, India, and São Paulo, Brazil. No Blood lists a total of 116 bloodless centers worldwide. [1]

The Englewood Hospital and Medical Center in Englewood, NJ has hosted a bloodless medicine and surgery center since 1994. They have received a total of $4.69 million in federal funds for expanding their scope since the inception of The Institute for Patient Blood Management and Bloodless Medicine and Surgery at the hospital. Most recently, the Institute received a grant of $1.49 million dollars. The recent grant is specifically with the military in mind, with the purpose of training both military and civilian physicians in bloodless surgery techniques. [2] This is seen as a significant preventive safety measure, should blood supplies in the future be interrupted or in short supply.

The executive director of the Institute, Aryeh Shander, M.D., noted the increasing need for bloodless surgeries. The medical staff at Englewood has over 200 physicians from over 25 branches of specialization trained in non-blood surgery. [8]

Additional considerations in bloodless medicine are economical. Dr.’s Shander A, Hofmann A, Gombotz H, Theusinger OM, Spahn DR.of Englewood’s bloodless surgery institute, state “in that shrinking donor availability and application of a precautionary principle to minimize transfusion risks are factors that continue to drive the cost of blood products upward,” and this is another consideration for the continued future expansion of bloodless medicine. [10]

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