Ruby456, et al: I have heavy demands of my time, and declining health. I am going to assume your comments are made in good faith, and do my best to briefly address them. This will, however, be a necessary final attempt.
The references to 150 deaths per year in the U.S. are in fact Dr. Muramoto's. Here is the original estimate that he prepared. In the second paragraph from the bottom, on the right, you will find the numbers in question.
http://ajwrb.org/wp-content/uploads/2017/08/BloodDeathsMuramoto.pdf
This estimate was prepared by Dr. Muramoto specifically for 2001 annual meeting of the American Society of Anesthesiologists in San Francisco. I was present along with about a dozen other members of AJWRB. I continue to be in contact with Dr. Muramoto even though he has retired, and he stands by his estimate, as does AJWRB for a multitude of reasons.
If you feel the need to dig deeper to convince yourself, that is understandable. Here is some additional material that addresses many of these issues related to Kitchens study:
http://www.bmj.com/rapid-response/2011/10/28/risk-blood-transfusion-illegal-breach-confidentiality-addendum-reply-furul
Bear in mind, you are reviewing the work of one of the best experts in this entire field. An author who has been published more times in peer reviewed medical journals than anyone else on this matter. Dr. Muramoto has produced a very, very conservative estimate which is precisely why we use it. It completely ignores all deaths related to the three primary causes of morbidity in JW's related to the blood issue. (Chronic blood disorders, trauma, and child birth). The estimate is certainly on the low side, and the fact that it is reasonable is born out by the study done by Beliaev almost 20 years later. This is actually a much better study for our purpose since it is based strictly on outcome related to anemia.
Clinical benefits and cost-effectiveness of allogeneic red-blood-cell transfusion in severe symptomatic anemia. Beliaev et al. VoxSanguinis 2012 July 103(1):18-24. https://www.ncbi.nlm.nih.gov/pubmed/22150804
A separate analysis and extrapolation performed independently by AJWRB Science Adviser Marvin Shilmer produced the identical mortality factor derived by Dr. Muramoto, namely 0.015% annually. The studies independently validate one another - you can take that to the bank.
As for any notion that Kitchens may have had about mortality and morbidity related to blood, he frankly admits he didn't know. That is not the case now. Its approximately 100:1 - not enough to materially impact our number in any significant way. The following quote in this regard is from Dr. Muramoto's rapid response in the BMJ listed above:
"The risk of blood transfusion was again extensively reviewed in the "Medical Progress" review in the New England Journal of Medicine in 1999.[6][7] In this progress review, the overall number of deaths from blood transfusion is estimated between 23 and 44 deaths per million units of blood. These numbers include every complication from blood transfusion, not just short-term mortality as in Sazama's report. The short-term mortality which corresponds to Kitchens' estimate should be smaller than these numbers. Thus, a typical blood transfusion of two units carry the risk of 46 to 88 overall deaths per million patients, or 0.0046 to 0.0084%. If a larger amount of blood is transfused, this risk will increase further, to 0.01 to 0.03%.
The accurate number itself is not as important as the magnitude of the risk. Available data indicates that the mortality of refusing blood is close to one hundred times greater than the mortality of being transfused. In the United States alone, about 1.5% of population has conditions requiring blood transfusion each year according to the statistics of the American Association of Blood Banks. That means about 15,000 of Witnesses in the United States will face such conditions each year. Not all of them need transfusion for major surgeries, but suppose half of them had major surgeries, about 7,500 Witnesses have about 1% of additional mortality according to Kitchens. To put this in perspective, 75 Witnesses are dying each year in the United States alone due to refusal of blood transfusion, whereas only about 0.01% of mortality, or life of less than one Witness, is spared by refusing blood transfusion and avoiding transfusion-related death. We never know the exact number of life lost and life saved by refusing blood transfusion. However we can estimate the magnitude of mortality from this practice with reasonable certainty. If we accumulate the above number over the past thirty years and extend to other countries, "hundreds and thousands of deaths from the blood refusal policy" is not at all an exaggeration."
