Advent of ‘Blood-Free Drugs’ Helping Some Patients Avoid Blood Transfusions – Consumer Health News | So Good News
Monday, Nov. 28, 2022 (HealthDay News) — Andrea Acerra, 45, before having a hysterectomy due to a prolonged period in November, was given iron to increase her red blood cell count and prevent the need for a blood transfusion.
“I was worried about the side effects of the iron, but there weren’t any,” said Acerra, an assistant professor of medicine in Bay Shore, NY.
South Shore University Hospital in Bay Shore, where Acerra was treated, offers bloodless chemotherapy as an option. The program screens people to see if they are eligible for bloodless surgery. Until now, surgeons have developed various methods of treatment without blood.
It is also known that blood transfusions are used when blood transfusions are not an option for religious or safety reasons. This principle was promoted by Jehovah’s Witnesses, who believe that it is against God’s will to receive blood from another person.. There are more than 8.6 million Jehovah’s Witnesses worldwide.
Blood transfusions became widely used in the 1980s due to fears that donated blood could be contaminated with HIV and hepatitis C. This is no longer a concern because blood donations in the United States are tested for these infectious diseases along with several others.
However, “there is a large part of people who cannot or cannot receive blood transfusions,” said Dr. Aaron Harrison, associate medical director and gastroenterologist at South Shore.
And thanks to bloodless medical procedures, many of them won’t need it, he added.
Having bloodless medicine as a solution became more important during the pandemic when blood donors dwindled, which caused a national shortage. “We don’t have blood available so if we can escape without using blood and do things carefully, that’s good,” said Harrison.
At South Shore, patients like Acerra are identified before surgery and if they are found to be anemic or unable or unwilling to receive a blood transfusion, they are placed on a blood transfusion or transfusion regimen.
“We train our doctors to tell the story of how we can increase preoperative blood volume, reduce blood loss and the need for transfusions,” said Harrison.
“It’s interesting, because I don’t think anyone else in the world has a plan to show patients,” added Dr. John Davis, South Shore’s chief operating officer.
The hospital already works with local Jehovah’s Witnesses, so the new program is a natural outgrowth, he said.
In addition to using iron and a hormone called erythropoietin (EPO), which tells the bones to make more red blood cells, there are other ways to reduce the risk of blood transfusion before surgery.
First, “we can reduce the number of blood tests before starting the procedure and use smaller tubes to collect blood,” Davis said.
Another way to reduce the chance of a person needing a blood transfusion is to stop using blood thinners before surgery to prevent excessive bleeding, said Dr. Steven Frank, medical director of the bloodless medicine and surgery program at Johns Hopkins Hospital. Baltimore.
It is also important to stop taking herbal medicines, vitamin E and nonsteroidal anti-inflammatory drugs (NSAIDs), as these can increase the risk of bleeding during surgery.
“Warming people during surgery also helps, because even mild hypothermia causes bleeding during surgery, and reducing blood pressure also reduces bleeding,” said Frank.
A drug called tranexamic acid may be given to stop the bleeding, he said.
And then there is technology that collects the blood you lose, washes it, and returns it during surgery. Frank said: “This is considered to be the foundation of blood protection.
The advent of robotic surgery has also reduced the risk of bleeding during surgery, he said. “Yes, robotic surgeries involve smaller cows than open surgeries, but the biggest difference is the blood loss and the lack of blood transfusions,” Frank said. “It’s like night and day.”
Blood transfusions can be life-saving, but they also present their side of danger.
Donated blood is not safe, Davis said. “Blood is ancient and the number of cells in each part that works and carries oxygen is part of the total cost.”
People can also hate the same blood, Frank said. “It is well known and proven that blood banked for transfusion can put you at risk of acquiring hospital-acquired diseases, as it suppresses your immune system,” he said.
Transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), and transfusion (ABT)-related immunomodulation (TRIM) are all risks of transfusion. TACO and TRALI are pulmonary complications that are the leading cause of transfusion-related deaths, Frank said.
“People forget about TRALI, TACO and TRIM, which are more common than getting HIV or hepatitis C from a blood transfusion,” he said. “Your chance of contracting HIV or hepatitis C from a blood transfusion is about the same as being struck by lightning — about 1 in 2 million.”
Blood transfusions are becoming more popular because of the list of potential benefits, Frank said. He said: “We all benefit from what we have learned from the group of Jehovah’s Witnesses.” “With the right planning, with the right people and the right treatments—almost any surgery can be done without blood transfusions.”
The Society for the Advancement of Blood Management has information on bloodless medicine.
SOURCES: Andrea Acerra, Bay Shore, NY; Aaron Harrison, MD, assistant medical director, gastroenterologist, South Shore University Hospital, Bay Shore, NY; John Davis, MD, chief of surgery, South Shore University Hospital, Bay Shore, NY; Steven Frank, MD, chief of medicine, program of clinical and vascular surgery, Johns Hopkins Hospital, and professor, surgery and palliative medicine, Johns Hopkins University School of Medicine, Baltimore