Hemosep - blood recycling system

by TheWonderofYou 15 Replies latest watchtower medical

• 

  TheWonderofYou

  Hemosep – blood recycling system

  A blood recycling system, the Hemosep cell savage, was developped at Brightwake Ltd. It is praised as costsaving and lifesaving device for JW who undertake major surgery. One of the company's trading arms Advancis Surgical markets the device. Professor Terry Gourlay of Strathclyde University, Department of biomedical engineering approached the company what lead to a cooperation with many institutions, surgeons and hospitals. On the way to the product hundreds of clinical trials with patients that needed cell savage were performed. A major partner of Prof. Gourlay in his project was the Nottingham located ottingham University Hospital, NUH and the turkish leading University of Kirikkale University Hospital in Ankara, Turkey where carried out over 100 open heart surgery operations and where Professor Serdar Gunaydin M.D., PhD. Is Head of the Department of Cardiiovascular Surgery. The company promotes application for a clinical trial even on its homepage. For many J.W. this would be saving straw.

  ____

  Former post already mentioned the new product
  https://www.jehovahs-witness.com/topic/279670/daily-mail-article-uk-blood-recycling-breakthrough-will-let-jws-have-major-surgery
  https://www.jehovahs-witness.com/topic/233851/new-technology-transform-blood-processing

  ____

  The Hemosep device is for many JW important and the background is a story about pioneers in the blood-saving surgery.

  Steve Cotton Brightwakes director in a Newspaper reports.

  "We are excited by its potential to help people whose particular religious beliefs mean that they cannot receive donated blood, even if they experience severe blood loss" "The technology could also save the NHS millions by reducing the demand for donated blood".http://www.dailymail.co.uk/news/article-2614169/UK-blood-recycling-breakthrough-let-Jehovahs-Witnesses-major-surgery.html#ixzz4NuTvBz8i

  _____

  A ground-breaking blood recycling system, the Hemosep cell savage, was developped at Brightwake Ltd. The company offers the possibilty to apply for a clinical trial for autotransfusion on its homepage.

  Brightwake presents itself as a creative development, engineering, production and research company called advanced wound care specialist, which is based in Nottingham. They are producing and selling special textil products like dressings and layers for medical and other usage like Manuka honey dressing in the Advancis Medical division. From Brightwake's origins in textile production, they have continued to grow and thrive in the medical sector. So Brigthwake developed expertise in textiles and textile construction and provides inventive solutions to companies servicing the professional medical, cosmetic, industrial, retail and aviation industries. It is able to develop and manufacture all products in-house at its factory in Nottinghamshire! The newer trading arm of the company is Advancis Surgical selling the Hemosep -blood recycling system -besides the established successful trading division Advancis Medical, which sells the dressing and layer products.

  "Hemosep was developed by Brightwake in collaboration with Professor Terry Gourlay of Strathclyde University. A key factor has been the company’s knowledge of textiles, which began in the 1980s making lacy trimmings and then elastic. Brightwake used this expertise to invent filters with microscopic meshes. These make Hemosep the only machine in the world capable of salvaging tiny platelets which help blood to clot. Returning such cells to the body lowers the risk of bleeding after an operation."
  http://www.buildingbetterhealthcare.co.uk/news/article_page/Nottingham_company_makes_breakthrough_with_blood_recycling_device/97756

  "Brightwake’s managing director, Steve Cotton, said: “We are extremely proud of Hemosep and excited by its potential to help people whose particular religious beliefs mean that they cannot receive donated blood, even if they experience severe blood loss.”
  Hemosep’s benefits have been welcomed by clinicians at Nottingham University Hospitals. Its deputy chief perfusionist in cardiac surgery, John Campbell, said: “It’s an extremely useful tool. By using it in this extreme case we have identified other potential areas where it could be used, such as obstetrics and major trauma."
  “When donated blood is transfused, the body has to work to clean it and there is no immediate way of knowing the quality of the red cells or any potential side effects. If it’s your own blood there are none of those issues. Patients who have transfusions are reported to have a longer stay in intensive care, compared to those who don’t."

  Economic benefit
  Patients who have transfusions are reported to have a longer stay in intensive care, compared to those who don’t
  https://pure.strath.ac.uk/portal/en/impacts/economic-and-health-benefits-from-use-of-the-hemosep-auto-transfusion-system-to-reduce-blood-transfusions-and-related-complications-during-openheart-surgery(d8e2dbe4-b1ca-41bc-b192-9f8f30111973).html

  Also in Nottingham is located the Nottingham University Hospital, NUH, which cooperates with the researchers, where between dozens and perhaps hundreds cinical trials with the new system Hemosep on patients with need of blood recycling system were already performed with Hemosep.

  Many trials were performed in other hospitals located in London and Turkey. (Guy's and St.Thomas in London, North Midlands Trusts or Papworth hospital* see article below

  The idea for hemosep was brought to Brightwake by Terry Gourlay

  "The machine was the brainchild of Terry Gourlay, professor of biomedical engineering at Strathclyde University in Glasgow.
  He took his idea to Brightwake, a Midlands-based firm, which makes wound dressings and other high-tech medical products.
  Founder Steve Cotton said: ‘It shows what is possible with a bit of British ingenuity.’ He has calculated the device could save the NHS more than £10 million a year by reducing the demand for donated blood."
  http://www.dailymail.co.uk/news/article-2614169/UK-blood-recycling-breakthrough-let-Jehovahs-Witnesses-major-surgery.html

  The pioneer Professor Terry Gourlay, he is working for this company and explains the new system: ............ " at the companies homepage. He is head of University's Department of Biomedical Engineering at the University of Strathclyde, Glasgow as well. Here is a list of his publications and his research e.g. about his measurements of blood cells.

  https://www.strath.ac.uk/staff/gourlayterryprof/

  http://www.strath.ac.uk/engineering/biomedicalengineering/

  For the product development of Hemopur a research cooperation was necessary to perform cinical trials with patients who need blood recycling. The "worldleading" (according to a selfdescription) University of Kirikkale University Hospital in Ankara, Turkey carried out over 100 open heart surgery operations.

  There Professor Serdar Gunaydin M.D., PhD., Head of the Department of Cardiiovascular Surgery at the University of Kirikkale, who is Professor of Cardiovascular Surgery Medline Hospitals, Ankara, Turkey. His medical background of education :

  Medline Hospital Eskisehir, Professor & Chair, Department of Cardiovascular Surgery, Kirikale University, Department of Cardiovascular Surgery, Kirikale University, School of Medicine, Chair, Numune Training & Research Hospital, Consultant Cardiovascular Surgeon and Associate Professor, Bayindir Hospital, Ankara-Turkey, Staff Cardiovascular Surgeon

  "The technology is a real step forward in the field of autotransfusion for cardiac surgery, being highly effective, easy to use and associated with a reduction in the need for donor transfusion and blood loss in these patients.
  "In the climate of national blood product shortages and concern for disease transmission and immunosuppression, every effort should be made to optimise blood recovery and reduce allogeneic blood usage.
  "The HemoSep technology has produced impressive results, it is the easiest method we have ever used. There is no interference with the ongoing operation and product is ready to use following a very short processing time. It quickly and safely recovers substantial proteins, clotting factors and cell concentrates for all types of cardiac procedures.
  "We believe this new technology will be one of the essential components of the routine heart surgery in the near future. We even think this technique may be useful for blood preservation during transplantation, orthopedics and neurosurgery."

  
  http://medicalxpress.com/news/2012-08-technology-blood.html

  http://www.miectis.org/speaker/serdar-gunaydin/ Picture!!

  http://www.ctsnet.org/home/sgunaydin background

  Serdar Gunaydin, M.D., PhD. Dr. Gunaydin is a Professor of Cardiovascular Surgery at University of Kirikale in Ankara, Turkey. He is the Director of Medical Services at Adatup Hospital, Sakarya, Turkey.
  He also serves as an Adjunct Professor for the Department of Biology & Cytology- Stem Cell Research Center, Hacettepe University, Ankara Turkey and as a Visiting Lecturer, Strathcylde University, Glasgow, UK.
  He continues his affiliation as a Visiting Professor for the Biomedical Research Foundation, Academy of Athens, Greece.
  He has been a practicing Cardiovascular Surgeon for over 25 years; he is the author of over 60 international publications and serves on the Editorial Boards of several medical journals.

  Dr. Gunaydin has recently released his book together with Prof. Gourlay “Minimized Cardiopulmonary Bypass Techniques and Technologies”.

  http://www.sciencedirect.com/science/book/9781845698003
  
• 

  TheWonderofYou

  BRIGHTWAKE Company's page with the picture of the pioneer Prof. Terry Gourlay who had the idea for Hemosep

  http://www.brightwake.co.uk/blood-processing_26.html

  http://www.brightwake.co.uk/hemosep-blood-processing-developed-at-brightwake-ltd_N2.html

  Professor Terry Gourlay, who led the development of the technology at the University's Department of Biomedical Engineering, said: "This is a fantastic example of real collaboration between the University of Strathclyde and the medical device industry to take this device from concepts to clinical delivery."
  "The introduction of HemoSep to the medical device field will make a significant difference to people's lives and greatly reduce the cost and risks associated with blood transfusions."

  Prof. Gunaydin: "We believe this new technology will be one of the essential components of the routine heart surgery in the near future. We even think this technique may be useful for blood preservation during transplantation, orthopaedics and neurosurgery."

  
  

  http://www.advancissurgical.com/

  The hemosep-story

  http://www.advancissurgical.com/hemosep/hemosep-story/

  Advancis medical division:

  http://www.advancis.co.uk/

  Report about the system

  https://www.cadth.ca/hemosep-new-system-ultrafiltration-and-blood-conservation-cardiac-surgery

  
  
• 

  OrphanCrow

  I am curious.

  Does anybody know at what point the Hospital Information Services get a kickback from this company?

  At what point in the distribution network is the HLC involved? This cell saver was trialed on Jehovah's Witness patients - that is an indication of HLC invovlement.

  And...are there JWs who profit from this company? Are there JWs invested in Advantis Surgical and/or Brightwake? Does Advantis sponsor any of the JWs who are in the HLC network?
• 

  TheWonderofYou

  Prof. Gunyadin contributes

  perfusion-lt.com and Perfusion University

  an institution for Perfusion and Blood Management Services

  http://perfusion-lt.com/bio-serdar-gunaydin/
  

  Biographies of the other members

  http://perfusion-lt.com/about/ biographies
  

  
  John Slickmeyer a Patient blood Management Technician, PBMT or CPMBT (consultant)

  articles of him ::: http://perfusion-lt.com/author/jslickjr/page/14/
  

  
  
• 

  OrphanCrow

  Advantis Surgical is the company that recently entered into a contract to supply the Hemosep machine to cardiac units in Canadian hospitals.

  https://www.cadth.ca/media/pdf/EH0019_Hemosep_e.pdf
  

  The Canadian JWs certainly aren't wasting the opportunity to promote this technology in the wake of Eloise's death:

  Jehovah's Witnesses defend hospital visits that push for bloodless treatment

  A blood death, from a pregnancy complication, in a Canadian hospital means that this machine can now be promoted for more than just cardiac units.

  Eloise's death is being used as a promotional tool for the bloodless industry.
• 

  TheWonderofYou

  
  

  It begins with "bloodless surgery"..... again this term, didnt we learn that it was rather "transfusion-less" surgery and that the term is false?

  This is an internationl site of neurochirurgy. http://neuros.net/en/jehova_witnesses/ with a complete strategy for encountering JW patients. Background is a good communication between HLC and the neurosurgeon-community.

  I looked if Hemosep was mentioned, but I found only Hemopur, obvioully once supported by HLC and the document should be updated because it is not up to date .
  

  The latest sentence in section JW-strategies is almost true, because Watchtower changes its position according to the market.
  "Special alternatives are offered on a separate document that describes each of the strategies, processes and products or components and allowed according to the latest data available from the Watch Tower."

  Shock... they are playing with lifes!!!

  Were the surgeons of Eloise in Canada allowed at all to receive the latest available data from the Watch Tower if the HLC didnt allow access to her room? It turned around her LIFE, and these guys ..snafued it.

  ::::

  Supported Products
  

  • Albumin (supported since 1981) and rHuEPO (stimulating protein formation of red blood cells).
  • Immunoglobulins and vaccines or serums (1974).
  • Antithrombin III.
  • Coagulation factors and cryoprecipitate.
  • Artificial blood (HemoPure®, PolyHeme®): They are called “oxygen-carrying solutions”. These new oxygen-carrying solutions are accepted, although they derive from animal blood. They are still not allowed by Spanish law, as they are in the experimental period.
  • 
    

  http://neuros.net/en/jehova_witnesses/

  

  Who do you think gives surgeons such clear instructions how to treat a J.W.?

  ______

  JEHOVA WITNESSES

  
  

  1. GENERAL GUIDELINES

  Watchtower, the official Jehovah’s Witnesses’ journal, understands that the law of God forbids or rejects without any doubt the whole blood transfusion, and its four main components (plasma, erythrocytes, leukocytes and platelets).

  However, there are many products, derivatives or techniques that are not rejected or banned. This means they are allowed. Some of the “smaller fractions” are not rejected. It is also allowed the use of some techniques of autotransfusion, as normovolemic hemodilution and blood salvage.

  Since Watchtower guidelines leave the conscience of every Jehovah’s Witness decision on many issues, the individual patient will be asked about each of the points that they personally accept or reject.

  The following are guidelines, and what modern medicine offers as an alternative.

  2. ALLOWED AND REJECTED DERIVATIVES

  Rejected products

  Whole blood

  Plasma: it consists the 55% of blood volume. 90% of plasma is water. 7% is albumin, immunoglobulins, fibrinogen and other fractions in the clotting process. The remaining 3% are nutrients and metabolic products. These fractions, separately, are accepted by most Jehovah’s Witnesses, but together (plasma) are rejected product.

  Leukocytes (white blood cells): These components are present in its greater proportion in transplanted organs and milk (both maternal milk and cow milk), where it is accepted.

  Erythrocytes (red blood cells): Present in the “packed red blood cells.” These cells constitute 40% of blood volume. They contain haemoglobin (97% of red cell volume), which is the oxygen-carrying protein. Products containing free haemoglobin are accepted.

  Platelets: constitute only 0’17% of blood volume.

  Supported Products

  Albumin (supported since 1981) and rHuEPO (stimulating protein formation of red blood cells).

  Immunoglobulins and vaccines or serums (1974).

  Antithrombin III.

  Coagulation factors and cryoprecipitate.

  Artificial blood (HemoPure®, PolyHeme®): They are called “oxygen-carrying solutions”. These new oxygen-carrying solutions are accepted, although they derive from animal blood. They are still not allowed by Spanish law, as they are in the experimental period.

  3. ALLOWED AND REJECTED TECHNIQUES

  Rejected Techniques

  These are mainly those that involve blood storage, i.e. predeposit technique. However, it accepts the components, the products of the processing of blood, which are stored later.

  Permitted techniques

  Acute normovolemic hemodilution (ANH) (Watchtower June 15, 1995)

  Intraoperative Recovery (Cell Saver)

  Postoperative recovery (autotransfusion drains)

  Medicine uses the term “autologous” to refer to these techniques. Watchtower says in its edition of March 1, 1989 that the ANH and intraoperative recovery (AIT with Cell Saver) are acceptable to most Jehovah’s Witnesses. Postoperative recovery with autotransfusion drainage system is similar to that of hemodilution and therefore is accepted.

  Conditions for applying these techniques

  Follow the recommendations WATCHTOWER

  The patient must accept the technical limitations, conditions and risks. This involves the signing of a special informed consent, in which each point is specified.

  WATCHTOWER Recommendations

  The summary is that any autotransfusion technique must, to be acceptable, involve the complete absence of disconnection between the circuit or system through which the blood and the patient, i.e., there must be permanent connection between the autotransfusion system and the system patient’s circulatory system.

  4. OTHER INFORMATION OF YOUR INTEREST

  Possible measures to supplement the no-transfusion

  Fluid: Crystalloid and colloid. These prevent hypovolemia, ie the lack of intravascular volume, but not carrying oxygen, with the risk of ischemia (lack of oxygen to the tissues). The patients with circulatory problems, irrigation deficit, angina pectoris, history of heart attack or stroke, and chronic lung problems, among others, can see their lives seriously threatened by ischemia subsequent to haemorrhage. The oxygen-carrying solutions are still in experimental stage and are currently not legally accepted.

  Drugs for the correction and prevention of anaemia: There are drugs that stimulate the formation of red blood cells (rHuEPO) and platelets (IL-11). Iron is easy to administer orally or intramuscularly. Intravenous iron (Venofer®) can be used in extreme cases.

  Drugs that cause vasoconstriction (but favour ischemia – lack of oxygen in some tissues) and that promote coagulation (but also may promote thrombosis and possible pulmonary embolism).

  Biological adhesives: fibrin sealants (Tissucol) and platelet sealants (it requires the removal of platelets from the patient’s blood. This technique is not always accepted). They do not produce immediate or perfect closure of bleeding vessels, but help the physiological process of haemostasis.

  Bleeding in surgical techniques: endoscopic techniques, minimally invasive surgery and microsurgery. They do not guarantee the non-bleeding, but generally have lower probabilities of bleeding.

  Equipment and surgical supplies: electrocautery, bipolar coagulator, ultrasonic aspirator CUSA Ligasure® sealing, endoclips, Spongostan®, Tissucol®, Surgicel®. These help to avoid the opening of the blood vessel, and the closure of the already open, but have a limit of vessel size and raw surface.

  Specific risk of the strategy of non-transfusion

  It is estimated that non-transfusion strategy adds a mortality risk of 0.5-1.5% to the patient’s own (The American Journal of Medicine, February 1993). This means that for every 100 patients undergoing bloodless surgery strictly, there is one that dies needlessly.

  This figure is well above the surgical-anaesthetic risk without the restriction of blood. According to recent statistics (Anaesthesia, 56 (12): 1141-1153) in 10,000 anaesthetics:

  There are 8.8 cases of perioperative death

  There are 0.5 cases of perioperative coma

  There are 1.4 deaths associated with anaesthesia

  That is, if the possibility of death or coma is 0.5-8.8 per 10,000 operations, the strategy of non-transfusion-risk places this 50-150/10.000 interventions. This means that the risk is 20-100 times higher.

  These statistics have been made in different years, and therefore medical technology may have improved this situation. However, we have not found in medical literature most recent statistics in terms of morbidity and mortality associated with strict non-transfusion strategy.

  Specific risk of transfusion

  These have been described in the summary of bloodless surgery program.

  Medical Problems

  The doctor is your ally in the fight against the disease. No doctor would carry out a transfusion if it is not necessary, nor prescribe medication or recommend surgery.

  Blood and its derivatives are not free of risk. But for the patient who really needs a blood transfusion, the risk of transfusion-associated diseases is much less than the risk of dying or falling more severely ill without the transfusion.

  Specific measures regarding autotransfusion

  Preoperative:

  Take oral iron Ferro-Gradumet 1 tablet every 12 hours fasting (before breakfast and before supper).

  If Hb <14g/dL or Hct <42%, which is the administration of rHuEPO. The guidelines will be established in conjunction with the Hematology Department.

  If possible, obtain platelet concentrate for the preparation of platelet glue

  Intraoperative:

  Intraoperative acute intraoperative hemodilution (ANH)

  Intraoperative Recovery (AIT)

  In future, application of platelet glue if required

  Postoperative:

  Preventing drainage

  If drainage is needed, apply drainage autotransfusion.

  How can I get assistance?

  ___________

  
  

  MEDICAL CONDITIONS

  BLOODLESS MEDICINE AND SURGERY: SOME OF THE METHODS

  1. GENERAL CONCEPTS

  INTRODUCTION

  Although blood transfusion can be done today with high security, is not without risks, the main one being transmission of infectious diseases (AIDS, hepatitis B and C, syphilis). It is also well known the shortage of treatment resources (allogeneic blood in blood banks). That is why in recent yearsautotransfusion programs and measures to reduce intra and postoperative bleeding have been developed.

  In the Hospital 9 de Octubre we have established a comprehensive bloodless surgery program (CSS program) whose main objective is to avoid allogeneic blood transfusion, using all means, resources and personnel which modern medicine puts at our disposal.

  MAIN OBJECTIVES OF THE PROGRAM CSS

  • Reduce the possibility of intra and postoperative complications related to blood transfusion (blood infections, transfusion reactions, alloimmunization, etc.)
  • Minimising the demand for blood from the blood bank, reserving it for cases that require it (oncology, critical emergencies, etc.).
  • Promote appropriate care to patients who for religious or other not wish to be transfused with allogeneic blood (Jehovah’s Witnesses).
  • Provide high-quality care.

  LINES OF ACTION

  There are several measures which, toghether, reduce the need for transfusion.

  • Optimum preparation of the patient to obtain adequate amounts of haemoglobin and red blood cells. During the preoperative visit iron treatment is prescribed until the day of surgery.
  • Reduced bleeding: bleeding in surgical techniques (endoscopic techniques, minimally invasive surgery, microsurgery). Equipment and surgical devices (electrocautery, bipolar coagulator, ultrasonic aspirator, heat sealing, endoclips, Spongostan, Tissucol, Surgicel). Pharmacological measures to reduce blood loss (hypotension, etc).
  • Autotransfusion Program: these are procedures for the extraction and storage of blood or blood components to a donor-patient for subsequent transfusion to the same person at the time of need.

  Autotransfusion programs

  Types of Autologous

  • Predeposit (preoperative autologous, or autologous blood predeposit)
  • Normovolemic hemodilution (Acute normovolemic hemodilution or ANH)
  • Recovery of blood (Blood savage)
  • Intraoperative recovery
  • Postoperative recovery

  The Haematology Department is responsible for the procedure predeposit. The other techniques are developed in the operating room and are the responsibility of the Department of Anaesthesiology and the various surgical services.

  
  Advantages of Autotransfusion

  • Eliminates the risk of transfusion reactions.
  • Eliminates the risk of transmission of infectious diseases.
  • Eliminates the risk of alloimmunization to red cells, white, platelets and plasma proteins.
  • Eliminates the risk of graft versus host disease.
  • Useful in patients with multiple alloantibodies or rare blood groups.
  • Lowers the number of postoperative infections.
  • Meets the need of blood in some Jehovah’s Witnesses.
  • Hemodilution improves oxygenation of the tissues by reducing blood viscosity.
  • Reduce the demands on the blood supply in times of shortage.
  • Psychological effect of patient participation in treatment.

  Disadvantages of autologous transfusion

  • Requires expert preparation of the specialists involved directly in the performance of each technique.
  • Each technique requires particular equipment, which is not present on a regular basis in all hospitals.

  2. Predeposit

  Predeposit consists of the collection of one or more units of blood in the patient candidate for surgery in the weeks leading up to it, if there are no contraindications to doing so. If the patient’s hemoglobin is low, we will evaluate the possible use of erythropoietin (rHuEPO), a substance that stimulates the formation of blood.

  These blood units are stored as predeposit in the Blood Bank properly identified. If the patient-donor needs a transfusion during or after surgery, he receives his own blood, donated previously.

  3. Acute normovolemic hemodilution

  Diagram of acute normovolemic hemodilution	Normovolemic hemodilution before the start of surgery

  This consists of obtaining in the operating room, just before surgery, a blood volume,compensated by adequate infusion of a given volume of fluid. The anaesthesiologist removes a number of bags of whole blood (between 1 and 4) which are available to be reinfused when the patient needs it.

  As a result, the patient’s blood is diluted, so that the net amount of haemoglobin lost during surgery is minor. At the end of surgery, when surgical bleeding has been controlled the blood obtained at the beginning of surgery is again reinfused.

  The fact that the vast majority of patients are candidates for ANH, low cost and the requirement of little manipulation technique, make the ANH technique is very affordable and practical.

  
  4. RECOVERY OF BLOOD

  It consists of the recovery of blood lost in surgery (in the surgical field and drains). Two methods allow the recovery of cells on the intra and postoperative period: Intraoperative recovery (IAT or Intraoperative Auto-Transfusion). It is recognized as the standard method of intraoperative autotransfusion, particularly very useful in surgery intraoperative bleeding (eg, total hip, lumbosacral arthrodesis). Postoperative recovery (PAT or Postoperative Auto-Transfusion)

  Diagram of intraoperative recovery of blood

  INTRAOPERATIVE autologous transfusion (IAT)

  It consists of collection of blood from the operative field, which is aspirated and led into a reservoir. Under standard conditions the red cells are separated, washed hemoconcentrated and stored in a bag, ready to be reinfused to the patient.

  The procedure requires special apparatus. The Surgical Area in Hospital 9 de Octubre is equipped with a modern Cell Saver-5, which allows not only the recovery of red cells, but also, in specific cases, other blood components, using specialized equipment to do so.

  The procedure is performed by the anaesthesiologist responsible for the patient. Since there is no connection at all times between the surgical fields – vacuum – recovery – blood bag – Infusion System – patient, there is no possibility of error as to confusion of identities between the patient and their bags of packed red blood cells.

  
  RECOVERY OF BLOOD WITH DRAINS (autologous postoperative)

  It consists of the collection of blood lost through drains in the early hours after surgery. The procedure requires a special drainage bag known as autotransfusion. The blood recovered, in bags, passes through special filters in order to be reinfused later. This technique allows the recovery of whole blood.

  
  5. PREPARATION OF PATIENTS FOR TECHNICAL intraoperative and postoperative autotransfusion

  These procedures are more effective the higher the baseline haemoglobin. Ideally, haemoglobin at baseline (before surgery) should be above and not exceeding 12g/dL 17g/dL. To support the achievement of this haemoglobin, we recommend prophylactic oral iron intake in all patients.

  In special cases (anaemia) may also consider the administration of erythropoietin (rHuEPO), a substance that stimulates the formation of blood cells, thereby increasing the net amount of haemoglobin.

  In the case of predeposit the criteria for drug administration will be individualized for each patient and the decision will be taken by the haematologist who performed the extractions.

  Jehovah’s Witnesses Strategies

  Surgical techniques to reduce bleeding, the optimal patient preparation, intraoperative hemodilution (ANH) and intraoperative recovery are accepted by the criteria of Watch Tower. It may also be eligible postoperative recovery. The predeposit is not admissible in any case.

  Intraoperative ANH and recovery are acceptable to most Jehovah’s Witnesses, subject to compliance with the recommendations of Atalaya and the patient’s request.

  Special alternatives are offered on a separate document that describes each of the strategies, processes and products or components and allowed according to the latest data available from the Watch Tower.

  How can I get assistance?
• 

  OrphanCrow

  That is a comprehensive post, Wonder.

  This part is interesting:

  Specific risk of the strategy of non-transfusion
  It is estimated that non-transfusion strategy adds a mortality risk of 0.5-1.5% to the patient’s own (The American Journal of Medicine, February 1993). This means that for every 100 patients undergoing bloodless surgery strictly, there is one that dies needlessly.
  This figure is well above the surgical-anaesthetic risk without the restriction of blood. According to recent statistics (Anaesthesia, 56 (12): 1141-1153) in 10,000 anaesthetics:
  There are 8.8 cases of perioperative death
  There are 0.5 cases of perioperative coma
  There are 1.4 deaths associated with anaesthesia
  That is, if the possibility of death or coma is 0.5-8.8 per 10,000 operations, the strategy of non-transfusion-risk places this 50-150/10.000 interventions. This means that the risk is 20-100 times higher.
  These statistics have been made in different years, and therefore medical technology may have improved this situation. However, we have not found in medical literature most recent statistics in terms of morbidity and mortality associated with strict non-transfusion strategy.

  ... for every 100 patients undergoing bloodless surgery strictly, there is one that dies needlessly.

  ...the strategy of non-transfusion-risk places this 50-150/10.000 interventions. This means that the risk is 20-100 times higher.

  
  
• 

  Crazyguy

  Isn't there a scripture that says that blood is to be poured out and wasn't it not to long ago jws were not to use any medical device that stored or recovered blood because of this scripture? Is this not more hypocrisy?
• 

  darkspilver

  Hi Crazyguy

  recovered blood because of this scripture? Is this not more hypocrisy?

  The principle for JW's is keeping the blood in effective continuous circulation.

  Believe it's a conscience matter and I think most JW's accept it, at least nowadays.

  Was told once by a publisher that they didn't want to accept cell salvage, I said - so you would not accept dialysis? - they said yes they would, to which I said it's basically the same principle - they changed their mind so would accept cell salvage.

  I understood that the basic/standard cell salvage thingy is used as 'standard' practiise nowadays on everybody due to both cost saving and reducing risks in transfusing someone else's blood into you.
  
• 

  OrphanCrow

  Some more information about the Hemosep machine that is distributed by Advantis Surgical/Brightwake.

  An American-Israeli company, Stratasys, supplies the 3D technology to create the Hemosep machine.

  http://www.breakingisraelnews.com/15065/israeli-3d-printing-creates-religiously-ethical-blood-collection-machine/#pzdJLw2z5XEdxOv1.97

  With the desire to get the HemoSep’s live-saving blood recycling technology on the market sooner, Brightwake turned to 3D printed prototype parts to save time and money. Dramatically shortening the production process of three weeks for outsourced products, Brightwake’s in-house use of the Stratasys 3D printer saved the company time and cut its prototyping costs by an astonishing 96 percent, saving about £1000 per piece.
  According to Cotton, “3D printing has not only enabled us to cut our own costs, it has also been crucial in actually getting a functional device to clinical trials. The ability to 3D print parts that look, feel and perform like the final product, on-the-fly, is the future of medical device manufacturing.”

  And about those clinical trials:

  http://jewishbusinessnews.com/2014/05/08/israeli-american-3d-printing-company-stratasys-to-make-life-saving-blood-recycling-machine/
  

  Hemosep has already undergone successful clinical trials in over 100 open-heart surgery operations in Turkey and now the device is being tested in England, primarily on religious patients who refuse the use of donor blood for major operations.