'Bloodless' surgery avoids risks of transfusion

"There's no downside to it that we can see, and there's certainly no downside that's been documented," Bridges said.

About a month before no-transfusion surgery, blood tests are conducted. Anemic patients receive weekly injections of medications, as well as intravenous iron supplements, to increase their red-blood-cell count.

During surgery, blood that gets suctioned or sponged out of the body cavity is salvaged, and highly efficient pumps keep blood circulating while the heart and lungs are stopped. After surgery, less blood is taken for post-operation tests.

"You have to be meticulous, you have to be organized, and you have to really work as a team before, during and after surgery," Bridges said.

Patients who choose the no-transfusion option eliminate the risk of blood-borne infection and complications from clerical errors. They also get out of the hospital an average of one day earlier and avoid potential transfusion-related complications including immune system suppression, inflammatory response, and renal or respiratory failure, Bridges said.

Bloodless surgery is also preferable to having patients transfused with their own blood, Bridges said. Blood that has been stored degrades and deforms outside the body and doesn't flow through blood vessels or carry oxygen as well when it goes back in.

The trend toward avoiding transfusions is gaining momentum among doctors and patients, said Dr. Patricia Ford, director of Pennsylvania Hospital's Center for Bloodless Medicine & Surgery. Transfusions are lifesavers during emergencies, but they can be avoided in most elective operations, she said.

"There is a movement that, for a lot of us, started as part of caring for Jehovah's Witnesses and learning about blood conservation and management," said Ford, who also is president-elect of the Society for the Advancement of Blood Management, a Wisconsin-based advocacy group.

The group said that the number of bloodless medicine programs nationwide has risen from 100 to about 120 in the past six years. The American College of Surgeons, a division of the American Medical Association, said it does not keep statistics on bloodless surgery.

"Transfusions are like getting a transplant; they can be risky and should be a last resort," Ford said. "Frankly, all of the things we use are available to every hospital. ... The hope is that every hospital will do this eventually."

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