Blood transfusions may not be needed in some surgeries
A recent study of almost 2,000 Jehovah’s Witnesses who underwent surgery without blood transfusions showed that they generally fared well. Jehovah’s Witnesses’ beliefs preclude them from accepting the blood of others.
“The study suggests that patients do not need blood transfusions if their blood count has not fallen more than 30 percent and that people with heart disease may require more blood during surgery than people without heart disease,” said Jeffrey L. Carson, MD, chief of the division of general internal medicine at the University of Medicine & Dentistry of New Jersey–Robert Wood Johnson Medical School in New Brunswick, which was part of the study. “However, more studies are needed to determine when blood transfusion should be given to surgical patients.”
The National Institutes of Health study, published in the British medical journal Lancet Oct. 19, examined 1,958 adult Jehovah’s Witnesses who underwent surgery without transfusions from 1981 to 1994 at 12 U.S. hospitals. The study found that only about 3 percent of patients died within a month of surgery, but the risk of death was 4.3 times higher among those with heart disease.
The death rate was about 25 times higher for patients with a hemoglobin count half of normal than for those with a near-normal count, Carson said.
Carson has applied for a grant to compare outcomes of patients receiving transfusions early in treatment with those not receiving transfusions until their hemoglobin count is half of normal.
According to researchers, further study may resolve controversy among physicians on how low hemoglobin levels can fall before transfusions. They say although the blood supply is safe, reducing transfusions will also reduce the risks involved.
Some hospitals are using bloodless surgery to meet the needs of certain groups of patients.
The large number of Jehovah’s Witnesses in the New York-New Jersey area prompted the Englewood Hospital and Medical Center, which was included in Carson’s study, to start a bloodless surgery program two years ago.
Although a vast majority of the patients who have undergone bloodless surgery are Jehovah’s Witnesses, they also included patients uncomfortable with the idea of transfusions or fearful about getting a bloodborne illness, according to Sherri Ozawa, RN, the program’s coordinator, who is a Jehovah’s Witness.
Since hospitals across New Jersey are competing for business, Englewood Hospital is promoting the bloodless surgery program to the 100,000 Jehovah’s Witnesses in the area. Englewood is one of the 53 U.S. hospitals that the 5-million member Jehovah’s Witness sect finds acceptable for members.
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