Procedures That Eliminate Blood Transfusions

Surgery patients often lose a significant amount of blood that must be replaced with transfused blood products. But several new techniques dramatically minimize or even eliminate the need for such transfusions. While primarily requested for reasons of faith, bloodless health care services offer many other advantages, and are being chosen by a growing number of patients.

Duke is committed to provide the latest blood-conserving surgical techniques to patients who seek to avoid transfusions for religious or other reasons. The Duke Center for Blood Conservation opened in 2004 and has successfully cared for over 500 patients who decline transfusion therapy. Combining the expertise of Duke faculty members and many other highly trained health care professionals, the center offers a variety of medically sound treatment options that help eliminate the need for blood transfusion.

Benefits Go Beyond Faith

Thirty-two-year-old Greensboro resident Kimberly Melton, who has ulcerative colitis, has coped with more than her share of serious health challenges. Her faith as a Jehovah's Witness provides her with spiritual strength to face her health difficulties, yet prevents her from accepting blood products during the surgical procedures that her chronic illness and related complications have made necessary.

So, a few years ago, Melton was happy to learn that Duke offers patients seeking to avoid receiving transfusions a broad array of blood-conserving surgical techniques. Of seven surgeries she has needed over the past several years, her last four procedures--including two hip replacements--were done at Duke.

Surgery patients often lose a significant amount of blood that must be replaced with transfused blood products such as red blood cells, platelets, and plasma. But several new techniques are dramatically minimizing or even eliminating the need for such transfusions. While these blood-conserving approaches to surgical care are primarily requested for reasons of faith, they offer additional advantages that are drawing growing numbers of other patients and many health care practitioners as well.

Blood-sparing techniques reduce exposure to viruses such as hepatitis C and help conserve the nation's blood supply. They also improve outcomes: One study found that patients receiving primary cardiovascular surgery without blood transfusion had comparable or fewer hospitalization days, lower rates of infection, greater patient satisfaction, and mortality rates equivalent to those who received blood.

Duke Program Offers Range of Options

In 2004, blood-conserving surgical techniques inspired the creation of the Duke Center for Blood Conservation. The center is one of just a few such programs nationwide. The Duke Center for Blood Conservation combines the expertise and perspective of Duke faculty members and many other highly trained health care professionals to provide patients with a variety of medically sound treatment options that eliminate the need for blood transfusion. Several Duke specialties participate in the program, offering bloodless procedures in specialties ranging from cancer care to cardiovascular surgery, gastroenterology to gynecology.

"We offer patients a number of treatment options to eliminate the need for blood transfusions," says Duke anesthesiologist Steven Hill, MD, who co-directs the Center for Blood Conservation with Jeffrey Lawson, MD, PhD, a general and vascular surgeon. Among the blood conservation treatments currently available at Duke are pre-surgery medical regimens to optimize red blood cell production before surgery; techniques that coagulate the patient's blood during surgery; "cell saving," or continually cleaning and recirculating the patient's own blood during procedures; and electro-cautery, which uses heat to stop bleeding.

Melton's illness had made her anemic, presenting a medical challenge that facilities located closer to her home couldn't easily address. "But at Duke, my low blood counts weren't a problem," she says. Duke surgeons performed her hip transplants with the assistance of hemodilution, which dilutes and recirculates the patient's own blood.

"Dr. Hill and the other members of the team went out of their way to make us comfortable, let us know our options, and reassure us that they respect our beliefs," Melton says. "And I really appreciated that."

To learn more about the Duke Center for Blood Conservation, call 1-866-500-4515.