{"id":6545,"date":"2022-12-19T21:29:38","date_gmt":"2022-12-19T18:29:38","guid":{"rendered":"https:\/\/jwforum.net\/portal\/?p=6545"},"modified":"2022-12-19T21:31:32","modified_gmt":"2022-12-19T18:31:32","slug":"the-surgeon-who-operates-without-transfusions-they-can-block-the-immune-system-and-cause-infections","status":"publish","type":"post","link":"https:\/\/jwforum.net\/portal\/the-surgeon-who-operates-without-transfusions-they-can-block-the-immune-system-and-cause-infections\/","title":{"rendered":"The surgeon who operates without transfusions: \u201cThey can block the immune system and cause infections\u201d"},"content":{"rendered":"

ROME \u2013 \u201cIn principle, being able not to transfuse is the best thing there can be for anyone. If blood loss control is done, the metabolic homeostasis, which indicates the general internal condition of the patient, is better because\u00a0every time you give a transfusion you have a blockage of the patient\u2019s immune system for two to three days and increase the risk of infection<\/strong>therefore the control of the patient\u2019s blood losses must be a must for everyone\u201d.<\/p>\n

\"\"<\/p>\n

Professor Rodolfo Capanna, surgeon expert in orthopedics and traumatology, former president of the European Association of Musculo Skeletal Transplantation (Eamst) and of the Italian Society of Orthopedics and Traumatology (Siot), and director of the UOC of Orthopedic Oncological and Reconstructive Surgery at the Cisanello Hospital in Pisa, also awarded among the best doctors in Italy at the \u201cTop Doctors Award\u201d, has no doubts. Interviewed by Dire he states that\u00a0avoiding transfusions would be to everyone\u2019s benefit<\/strong>.<\/p>\n

A journey that began thanks to Jehovah\u2019s Witnesses who, for reasons of religious belief, do not give their informed consent to transfusions even in emergencies and who, thanks to the constant work of their\u00a0health\u00a0care committees, have opened a gateway into the medical\u00a0world.<\/p>\n

TRANSFUSION AND RISK OF CANCER RECURRENCE<\/strong><\/h3>\n

\u201cIn a cancer patient, transfusion can increase the risk of recurrence<\/strong>\u00a0but above all of infection and in that case the chemo treatments are skipped if you have an infection \u2013 explains the surgeon \u2013 On the other hand, even the personal response to the tumor with too severe anemia leads to other consequences and therefore it is necessary to balance the case by chance,\u201d he continues.<\/p>\n

In his career, he says, \u201cI have operated on hundreds of Jehovah\u2019s Witness patients both over the many years at Rizzoli, both in Florence and in Pisa, and we have always tried to respond to their requests and in the vast majority of cases we have succeeded\u201d.<\/p>\n

WHAT TO DO IN THE OPERATING ROOM<\/strong><\/h3>\n

The remedies to be prepared in the operating room in order not to reach full-blown emergencies are: \u201cIn extreme situations with rapid and massive losses of blood, there is a risk of losing the patient, but\u00a0in planned surgery you can implement many strategies\u00a0<\/strong>as a preoperative therapy with erythropoietin, hypotensive anesthesia, you can do \u2013 continues Capanna \u2013 the intraoperative recovery of blood losses and there are technologies to make patients bleed less, from balloon catheters in large vessels, to cryotherapy.\u00a0If there is a large tumor mass, there are probes that freeze it<\/strong>and also haemostatic glues to avoid bleeding from the great vessels\u201d.<\/p>\n

Professor Capanna faces a very demanding surgery involving tumors of the bones and soft parts: \u201cIt is a surgery of necessity and demanding both for the removal of the tumor and in the reconstructive part which requires massive donor transplants, mega prostheses, 3D prostheses, or microsurgery with very long and complex interventions with vascular reconstruction or large demolitions of the pelvis, but also for more general orthopedics, such as knee or hip prostheses; in these cases the critical hematocrit represents a problem \u201d, he points out, drawing attention to how much it is necessary to do everything possible to never find oneself in those emergency conditions.<\/p>\n

THE RESISTANCE OF SOME DOCTORS<\/strong><\/h3>\n

Do doctors resist saying goodbye to transfusions? \u201cThere is no longer a prejudice \u2013 according to the professor \u2013 I believe that for a psychological question the doctor always has before him the risk that the patient, even for a trivial operation (if an artery breaks, there is a hypotensive collapse , something unexpected), may die and\u00a0the need to have a life-saving transfusion is an unavoidable thought for the doctor<\/strong>. Everyone has his creed. As a doctor, I cannot conscientiously accept that my patient dies during an operation, but \u2013 explains Capanna \u2013 if one tries to restore blood volume and oxygenation at all costs, if one puts into play everything I was saying, one cannot you get to put yourself in that extreme situation and therefore those who refuse transfusions feel sure that you will do everything not to do it and this creates trust and harmony\u201d.<\/p>\n

THE HEALTHCARE COMMITTEES OF JEHOVAH\u2019S WITNESSES<\/strong><\/h3>\n

In this regard, Capanna commented the experience of collaboration with the\u00a0health\u00a0care committees of Jehovah\u2019s Witnesses as \u201cvery positive\u201d.\u00a0A moral obligation is assumed with a patient who does not authorize a transfusion<\/strong>, and as a doctor I accept this belief of theirs. Some doctors do not accept this condition, \u201cthey claim to be authorized to carry out transfusions \u2013 comments the professor \u2013 but if one stiffens in one\u2019s positions, trust is lost\u201d, he concludes.<\/p>\n","protected":false},"excerpt":{"rendered":"

ROME \u2013 \u201cIn principle, being able not to transfuse is the best thing there can be for anyone. If blood loss control is done, the metabolic homeostasis, which indicates the general internal condition of the…<\/p>\n","protected":false},"author":1,"featured_media":6546,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[57],"tags":[],"class_list":["post-6545","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical"],"_links":{"self":[{"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/posts\/6545","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/comments?post=6545"}],"version-history":[{"count":1,"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/posts\/6545\/revisions"}],"predecessor-version":[{"id":6547,"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/posts\/6545\/revisions\/6547"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/media\/6546"}],"wp:attachment":[{"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/media?parent=6545"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/categories?post=6545"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jwforum.net\/portal\/wp-json\/wp\/v2\/tags?post=6545"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}