NEW YORK: Jehovah’s Witnesses, whose faith forbids them from blood transfusions, recover from heart surgery faster and with fewer complications than those who do get blood, a study has found.
Patients who are Jehovah’s Witnesses had better survival rates, shorter hospital stays, and fewer additional operations for bleeding than those who had blood transfusions during surgery, the study, published in the Archives of Internal Medicine, showed.
Members of the Jehovah’s Witness faith undergo extensive blood conservation before surgery, including red blood cell boosting erythropoietin drugs, iron and B-complex vitamins to guard against anaemia. The practice offered a ”unique natural experiment” for scientists to study the effects of the blood management strategy and may point to ways to reduce the need for transfusions, researchers said.
”How we care for Jehovah’s Witness patients with this pretty extreme blood conservation doesn’t put a patient at increased risk,” said one of the authors of the study, Colleen Koch, who is also a professor of anesthesiology at the Cleveland Clinic in Ohio. ”Perhaps it needs to be examined more closely [by] applying some of these practices to our routine cardiac surgery patients.”
The study included 322 Jehovah’s Witness patients and 87,453 other patients who underwent heart surgery at the Cleveland Clinic from 1983 to 2011. All Jehovah’s Witness patients refused blood transfusions. In the other group, 38,467 didn’t receive transfusions while 48,986 did.
The authors wanted to look at the difference between patients who receive blood transfusions during surgery and Jehovah’s Witness patients, who undergo strict blood conservation practices before, during and after surgery, Professor Koch said.
While many patients do not have blood transfusions during and after heart surgery, they also do not undergo the same blood conservation practices as Jehovah’s Witness patients, she said.
The study found Jehovah’s Witnesses had lower occurrences of a heart attack following surgery and less need for prolonged ventilation. They also had an 86 per cent chance of survival at five years and a 34 per cent chance of survival 20 years after surgery, compared with 74 per cent at five years and 23 per cent at 20 years for non-Jehovah’s Witness patients who had transfusions.
Victor Ferraris, who wrote an accompanying editorial in the journal, said there were various ways to conserve blood and prevent the need for a transfusion.
Instead of patients being placed on a heart-lung machine, which takes over the operations of the heart and lungs during surgery, he said doctors may want to consider operating while the heart is still beating to reduce the risk of bleeding and the need for transfusions. Patients can also be given drugs to help reduce their risk of bleeding.
”The question to ask is why don’t they do that for everybody,” said Dr Ferraris, a professor of surgery at the University of Kentucky in Lexington. ”We’ve proven we can do really good blood conservation and maybe we should expand this to a broader audience and really focus on limiting bleeding and blood transfusion.”
Bloomberg
