Cardiac surgery is one of the most common reasons for requiring blood transfusion, but Australian surgeons treating Jehovah’s Witnesses have shown that ‘bloodless surgery’ can be safe and effective.

Surgeons at the Prince Charles Hospital in Brisbane have reviewed the treatment of  49 Jehovah’s Witnesses who refused blood products because of their religious beliefs and found that they had similar outcomes after cardiac surgery to other patients who had CABG or cardiac valve surgery.

Writing in the journal Heart, Lung and Circulation (online 1 September), Dr Balu Bhaskar and colleagues say the use of blood conservation techniques ensures that patients who refused blood had the same operative mortality, post-operative outcomes and rates of ICU stay.

They say that in usual practice between 30-90% of patients undergoing cardiac bypass surgery will require blood transfusion, but this was avoided in Jehovah’s Witnesses by the use of ‘blood sparing protocols’, which included peri-operative blood conservation, the sue of haemostatic and haemopoietic drugs, reinfusion of shed blood and fastidious surgical techniques.

“Progressive advances in perfusion technology and peri-operative supportive management have made it possible for members of the Jehovah’s Witnesses religious group to undergo open cardiac operations with remarkable safety,” they conclude.

They go further and say that the protocols for bloodless surgery should not be limited to Jehovah’s Witnesses “but should form an integral part of everyday surgical practice” as more evidence emerges of the adverse effects of liberal usage of blood products such as  the risk of allergic reactions and transmission of diseases such as hepatitis C.

—-

Originally published in 6minutes, a daily electronic PDF newsletter for Australian doctors, published by Reed Business Information.