Mar 19, 2006 By Carol Kekela 5 min read

For those in need of a blood transfusion and whose religious convictions or individual concerns prohibit the process, an alternative program is being offered by Allegheny General Hospital (AGH) in Pittsburgh. More than 200 people from the Fayette County area gathered at the Route 40 Holiday Inn in Uniontown Saturday to learn about a unique program at AGH that offers patients in need of surgery the option of forgoing blood transfusions.

“Whether due to religious convictions or concerns over the safety of blood transfusions, a growing number of people in our country are expressing an interest in bloodless medicine programs. At Allegheny General, we have established one of the nation’s most comprehensive centers to accommodate such patients,” said Perry Doebler, a coordinator of AGH’s Center for Bloodless Medicine and Surgery.

The alternatives are all available at AGH and for those specifically to the Jehovah’s Witness congregations since religious convictions prohibit blood transfusions.

Several other reasons why the alternatives are desirable to a patient are because it avoids contracting a disease, a reaction, quicker recovery, lower costs and lower risks of cancer.

“Most blood transfusion patients fear diseases such as HIV, HCV, Hepatitis B and others,’ Doebler said. This program takes away those chances.’

The rates, Doebler explained, for getting HIV from a blood transfusion is one in 1.7 million; HCV, 1 in 1.5 million; and Hepatitis B, one in 166,700.

The Center for Bloodless Medicine and Surgery at AGH was established in 1998.

One process involves an intraoperative blood salvage or the “cell-saver system,’ whereby the system collects and returns the patient’s own blood lost during surgery.

Another technique, Erythropoietin, involves a synthetic hormone, Procit, that stimulates the body’s ability to produce red blood cells.

“By treating anemia and increasing the red blood cell supply before surgery, the hemoglobin level is increased and remains higher during and after surgery.’

This process would be done at 21 and 14 days before surgery, the day before surgery and the day of surgery, thus eliminating the need for having blood stored from oneself or relying on blood from a blood bank.

Other measures include Hemodilution, a temporary replacement of blood with intravenous fluids to reduce blood loss, volume expanders whereby the blood is “watered down” the blood contains a lower concentration of red blood cells and the amount of (cell) lost is reduced.

And other alternatives include use of an Argon beam coagulator, a blood clotting process; Electrocautery, use of heat to stop vessels from bleeding; blood-conservation, micro-sampling, whereby very small amounts of blood are taken for testing; skin monitoring, a non-invasive method of tracking oxygen levels during surgery; pharmacological agents; and meticulous surgical techniques to minimize blood loss.

Most of the 200 attending Saturday’s session were Jehovah’s Witness members. Their belief that accepting whole blood or any of the four primary components of blood violates God’s law because blood is sacred.

According to the Watch Tower Bible and Tract Society, “Jehovah God told our common ancestor Noah that blood must be treated as something special and by rejecting God’s law, one could contaminate others.’

With that belief, Louisiana Jones from the Brownsville Kingdom Hall, who moved here from Maryland, said the alternatives at AGH are very encouraging to congregation members.

“We will not have blood transfusions, honoring our belief,” said Jones.

“These alternatives to blood transfusions still honor our beliefs and will be helpful if ever needed.’

Jehovah’s Witness members deeply hold their religious convictions that blood transfusions are something they are not willing to accept, no matter the situation.

Jones said she has never had the need for a blood transfusion.

If ever the need would arise and was needed to save her life or family member, they would refuse.

“We would die,’ she said.

A Jehovah’s Witness man said his concern involves his age element and the fact he may need hip surgery sometime down the road.

“I can’t walk as well as in my younger days,” said the elder man, who asked not to be identified.

“I may have to have hip surgery, but won’t go through it if I felt I would have to have a blood transfusion.’

Doebler explained much blood loss is common in hip surgeries and the alternatives would be very helpful in recovery.

The AGH Center for Bloodless Medicine and Surgery treats approximately 200-300 patients per year, some traveling from as far away as Florida, Arkansas, West Virginia and Ohio. At AGH, highly complex surgical procedures, such as organ transplantation, brain, vascular, gynecological, cardiac, orthopaedic and gastrointestinal surgery can be performed without the necessity of transfusion.

According to AGH coordinator Deborah Tatro, “successful bloodless medicine programs require first and foremost an experienced, uniquely dedicated medical and surgical staff. At AGH, physicians representing just about every major clinical specialty are accessible to patients requiring a bloodless option for their care.”

She explained that the need for such a program sparked about two to three years ago when the West Nile virus was spreading here.

“We saw an upswing in the concern for blood transfusions and the concerns Jehovah’s Witness members had in avoiding contamination,’ Tatro said.

Those interested in contacting the AGH Center For Bloodless Medicine and Surgery may call 412-359-8787 or 1-877-284-2000.