Brain Surgery Possible Without Blood Transfusion
http://dailynews.yahoo.com/h/nm/20010725/hl/blood_1.html
NEW YORK (Reuters Health) - Patients who object to blood transfusions for religious reasons may still be able to safely undergo brain or spinal surgery, researchers report. In a new study, patients who refused blood transfusions for religious reasons fared almost as well as ``control'' patients undergoing similar procedures who did have blood transfusions.
Jehovah's Witnesses are forbidden by their religion to receive medical treatment that involves the administration of blood transfusions or blood products, even where such treatment could be lifesaving. But these patients sometimes accept the use of blood-free products called volume expanders--solutions that are mixed with their own blood to make up for blood lost during surgery--or agree to allow their own blood to be collected and ``recycled'' during the procedure with a device known as a cell saver.
Dr. Silke Suess of the Free University of Berlin, Germany and colleagues looked at the outcomes of neurosurgery performed on 103 Jehovah's Witnesses and 515 control patients who underwent similar surgeries. Most of the patients had brain or spinal diseases, such as a brain tumor or herniated disc, although a few had head injuries.
Blood loss during surgery was 35% lower in spinal surgery and 40% lower in brain surgery for Jehovah's Witnesses than for the other patients, suggesting that surgeons took more steps to limit and control bleeding during the surgery.
On average, it took surgeons 18 minutes longer to perform a spinal surgery and 37 minutes longer to perform cranial surgery on a Jehovah's Witness patient compared with a patient who did not object to blood transfusions.
However, six patients (4%) in the Jehovah's Witness group did suffer blood loss sufficient to require extended time in the intensive care unit and more days convalescing. In comparison, about 8% to 20% of the control patients experienced significant blood loss, and 15 of those patients required a blood transfusion.
On average, Jehovah's Witnesses spent 15% more time in the hospital than the control group did, the authors report in the August issue of the journal Neurosurgery.
``Neurosurgery traditionally has been very bloody. It does not have to be so,'' Dr. Patrick J. Kelly of the New York Medical Center in New York City writes in an accompanying commentary.
``Minimally invasive procedures and attention to (stopping blood loss) can reduce intraoperative blood loss considerably,'' he added.
``If we are to perform surgery in (Jehovah's Witness) patients, we must play by their rules, which, in my opinion, are not as onerous as some may believe,'' Kelly concludes.