What is bloodless surgery?

March 24, 2011 4:20:42 PM PDT
Bloodless surgery started out as an alternative for some religious groups, but is now becoming more mainstream. And a Philadelphia hospital is becoming the national model for this growing movement in medicine.

The goal is to conserve and make better use of a precious resource - blood.

Jock Davis of Rochester, New York, may not look sick now, but for years, the 48-year-old businessman has been battling a deadly blood cancer called Multiple Myeloma.

Chemotherapy helped, but became less effective. He needed a stem cell transplant, but there was a hitch:

"They do this procedure in my area, but no one does it without transfusions," Davis said.

He's right. Most of the time, stem cell transplants also require whole blood transfusions and as a Jehovah's Witness, that is against Davis' religion.

So he found Dr. Patricia Ford at Pennsylvania Hospital's 'Center for Bloodless Medicine.' In fact, Dr. Ford has done more "bloodless" bone marrow transplants than anyone in the U-S. Jock Davis was her 100th patient.

And every year, she guides about 700 patients through everything from heart surgery to hysterectomies - all without transfusions.

To do the transfusion-free transplants, she says, first, a patient's own blood count is built up.

"There's a lot of strategies by using iron and folate, and some injectables that we use to stimulate the bone marrow to make some blood cells," Dr. Ford said.

In addition to that, blood is conserved, by drawing less blood for testing.

After the procedure, patients are monitored closely and given medications to prevent bleeding.

At Pennsylvania hospital, the same blood management techniques are used for other surgeries, as well.

Jennie Gallina has been getting those blood-boosters for several weeks, to prepare for a double knee replacement. She, too, is a Jehovah's Witness.

But the techniques aren't just for people with religious objections to transfusions.

Many are now standard throughout Pennsylvania Hospital, and they are attracting patients from throughout the East.

For joint replacements, Dr. David Nazarian may have patients donate their own blood half an hour beforehand. It will go back to them after surgery.

Dr. Nazarian likes it because there's less risk of transfusion-related infections and the blood is fresher than when donated weeks ahead of time.

During surgery, he also uses smaller incisions to limit blood loss and a Cell-Saver machine to collect blood, filter it, and give it back to the patient.

"They're getting their own blood blood back, which of course, is much better for patients, and more patients desire that technique," Dr. Nazarian said.

As for Jock Davis, his prognosis is good. He is going home, thankful Dr. Ford and her team were able to help him.

"They accepted what my beliefs were and they worked with that," Davis said.

There are more than 120 bloodless surgery centers across the country, but the variety and succes of Dr. Ford's techniques are drawing special attention. The Joint Commission, the agency which accredits U.S. hospitals, has begun a review to determine if hospitals nationwide should adopt some of the measures.

Advocates say "bloodless medicine" often mean a faster recovery time and shorter hospital stay. They also put less stress on the nation's blood supply, and in these days of escalating health costs, they can save money, tool.

"I'm really hopeful that a lot of the things we use are going to become commonplace, not just in bloodless centers, but that all hospitals will have an expertise in the best way to utilize our blood products, says Dr. Ford.

The biggest risk is losing too much blood. This is something patients have to discuss with their doctor.

For more information, see the Center for Bloodless Medicine.