Word: bloodless
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...declined to perform a Whipple procedure, a complex reconstruction of the digestive tract rarely performed on a child. Rodriguez's parents had refused a blood transfusion, and the girl's doctors felt that without it the operation was even more risky. Undeterred, Englewood surgeons did a 10-hour bloodless Whipple. There were no major complications, and a week later Cristali was eating pizza. Soon after her discharge, she was back in school...
...Jehovah's Witnesses, who have long demanded equal medical care without having to compromise their religious beliefs, have made up some 90% of those who seek the bloodless techniques. But increasing numbers of other patients today refuse transfusions out of fear of blood-borne diseases such as AIDS and hepatitis, not to mention unidentified viruses...
Other factors make bloodless surgery increasingly attractive. Transfusions can suppress the immune system, for example, leaving a patient open to infection, slower healing and a longer recovery time. "Also, banked blood, after it's cooled and stored, doesn't have the capability of fresh blood to transport oxygen," says Shander. "We're just beginning to understand what it is we do when we give a transfusion." Finally, there is the cost: at around $500 for each transfusion, plus administrative add-ons, the total bill comes to between $1 billion and $2 billion annually, more than enough incentive to consider alternatives...
...blood, and large-scale clinical trials have yet to be performed. Last year an nih-funded study tried to get some answers. Dr. Jeffrey Carson, chief of the division of general internal medicine at the Robert Wood Johnson Medical School in New Brunswick, N.J., studied records of 1,950 bloodless-surgery patients in an effort to determine the relationship between patients' hemoglobin levels and the risk of dying or developing complications after surgery...
...Shander, the problem is a more personal one. "When we're challenged, we extend ourselves," he says. "Some of my colleagues have adopted bloodless medicine purely as a technique. Others have learned that it also has an impact on ethical and humanistic values. I feel that once you become philosophically committed to practicing bloodless surgery, the benefits to patient and physician alike become more and more apparent. Those are my greatest rewards...