In recent decades, many operations that once required a blood transfusion using donated blood are now being performed without the use of blood products. In many of these cases, the patients receiving the operation voluntarily elect not to have a transfusion. These patients instead opt for alternative medical procedures, commonly referred to as bloodless surgery.

Patients’ reasons for seeking alternatives to blood transfusions vary. Some have strict religious beliefs that do not allow for a transfusion; Jehovah’s Witnesses are the most well known group of people who do not receive transfusions for these reasons. Others prefer a bloodless approach to surgery because they are concerned with the risks associated with receiving a blood transfusion with donor blood.

The rise of HIV and AIDS awareness in the mid to late 1980s is partially responsible for patient concerns with the safety of receiving donor blood. In the US, blood used in a transfusion comes from blood banks located throughout the country. According to the U.S. National Blood Data Resource Center, more than 15 million units of blood are donated every year. This volume of donated blood comes from more than eight million blood donors.

U.S. institutions collecting donor blood have strict donation requirements. Potential donors who have recently traveled abroad, received a piercing or tattoo, have certain medical conditions, or have been exposed to sexually transmitted diseases are just a few examples of people who might not qualify to donate blood. In fact, the complete list of health conditions, medications, lifestyle and travel habits that are screened during the blood donation process is exhaustive.

Yet, even with strict screenings, evaluations and testing procedures, there still are patients in the US who contract serious infectious diseases from donor blood received during a transfusion. There are documented cases of patients contracting HIV, Hepatitis (B and C) and West Nile Virus from contaminated blood.

In addition to the danger of virus and disease, the US blood supply may be at risk in other areas. Because of the strict blood donation requirements necessary to obtain the safest possible blood, shortages are not uncommon. This happens often for patients who require a rare blood type. However, even patients with common blood types (such as O and A positive) can encounter blood shortages. In many cases, the availability of a particular type of blood depends more on when and where the patient needs it rather than what blood type is needed.

Although these and other risks are present in the US blood supply, this by no means indicates that blood transfusions are “unsafe.” While some patients prefer transfusion alternatives, such as bloodless surgery, the fact remains that millions of blood transfusions are successfully performed every day, and that these transfusions improve the health and survival of the transfusion recipient.
About The Author

Norman A. Smyke Jr, MD, is a board certified specialist in Anesthesiology and is the director of the Center for Blood Conservation at Grant. Dr. Smyke oversees the first bloodless medicine program in Columbus, Ohio and outlying areas to provide formally recognized blood management services, including bloodless surgery. For more information about the CBC at Grant, please visit Ohio Health.

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