Bloodless surgery is more than just 'another option' - it can save lives. The truth is though that transfusions of blood and blood products save many more lives.
There has been a misconception that bloodless surgery is relatively risk free when compared to traditional techniques using blood but is this position justified?
The following chart and report gives the opinions of medical staff.
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Bloodless surgery avoids some risks, invites others
By SHARON TUBBS
© St. Petersburg Times, published April 9, 2001
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Bloodless surgery centers have become more popular in the past 20 years, with at least 80 major facilities existing nationwide.
Jehovah's Witnesses, who don't believe in blood transfusions, are the centers' primary clients. But anyone can use them, and medical experts now ponder how broadly transfusion-free techniques should be applied.
Dr. Richard Spence helped start a bloodless center last fall at Baptist Health Systems in Birmingham, Ala., where he is the director of surgical education. There, doctors tell patients about the option of not using blood, regardless of their religion, Spence said.
"In using blood, risk is prevalent," Spence said. "People clearly want to avoid the risks if they possibly can."
And, frankly, blood isn't cheap, Spence said. With all the necessary testing, it costs his hospital about $600 to bring one unit (commonly called a pint) to a patient's bedside. That doesn't even include staff labor costs. The universal bloodless approach saved the private hospital $2-million in one year, Spence said.
Like the bloodless surgery center established at Tampa General Hospital in February, the private Alabama hospital uses various transfusion-free techniques.
Patients can donate their own blood ahead of time or take special drugs that increase blood cell count prior to surgery. In another procedure, doctors take some of the patient's blood before surgery, replace it with a non-cellular fluid, then inject the patient's own blood after surgery.
In the operating room, doctors might use a vacuum-like machine, called a cell-saver, that sucks in lost blood, cleans it and funnels it back into the patient's bloodstream. Some doctors use techniques to make cuts cleanly and meticulously, which decreases bleeding.
Jehovah's Witnesses vary on their opinions of whether some of the methods are acceptable under church doctrine.
Bloodless options are good for Witnesses, said Jeffrey Carson, chief of the division of general internal medicine at the Robert Wood Johnson Medical School in New Jersey. But he cautioned against a wholesale approach.
"The premise of these programs is that you don't have to get blood, and I think that's not true. I think there's a lot of instances where blood is life-saving," Carson said. "We have been in a number of situations where I have observed a patient die when I think we could have saved the life. . . . It's distressing. But, ultimately, it gets back to respecting the beliefs of our patients."
Dr. Harvey G. Klein, president of the American Association of Blood Banks, said bloodless techniques have not eradicated the need for transfusions in many situations.
For instance, hip surgeries and organ transplants require transfusion because so much blood is lost, Klein said. He acknowledged, though, that there have been cases where Jehovah's Witnesses survived such surgeries without transfusion.
Klein also noted that the risks of infection from tainted blood today are nearly nil. The chance of getting HIV is one infection for every 1.5-million units of blood transfused. The chance of getting hepatitis C is one for every 350,000 units.
"I'm a strong supporter of these procedures," said Klein, who is also a scientific adviser for the Johns Hopkins Center for Advanced Transfusion Practices and Blood Research. But, he added, "You can't always eliminate the need for blood."
URL http://www.sptimes.com/News/040901/Floridian/Bloodless_surgery_avo.shtml
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Bloodless Surgery Avoids Some Risks, Invites Others 
URL http://www.sptimes.com/News/040901/Floridian/Bloodless_surgery_chart.shtml