It’s a relatively common theme: After being a runner since your teens, you find yourself with chronic knee pain in your 50s or 60s. Your doctor tells you you’re a candidate for knee replacement surgery, but there is one catch – you want to have a bloodless, or transfusion-free, surgery.
More requests for bloodless surgery
Whether for personal or religious reasons, more New Yorkers than ever are requesting bloodless surgeries. According to Sandra Gilmore, Director of the Center for Blood Management and Bloodless Medicine and Surgery at Beth Israel Medical Center, select hospitals have stepped up to the demand.
“In the past three years, our enrollment at the Center for Blood Management has doubled, and our participating list of physicians has tripled,” Gilmore says. Today, most surgeries, from orthopedic joint replacements to complex cardiac, gynecological and urologic procedures, can be performed at Beth Israel Medical Center using techniques that avoid the need for a blood transfusion.
What are the alternatives?
At the Blood Management Center, physicians aim to reduce the need for blood transfusion in surgical and pre- and post-operative treatments. “Physicians are encouraged to critically evaluate the patient and the symptoms to see if there are alternatives to transfusion,” Gilmore says. Some of these alternatives include:
- Pharmaceuticals, including vitamins, supplements and prescription medications to grow new blood products.
Example: A pregnant woman suffering from anemia visits the center. Upon examining her lab work, her obstetrician discovers that her anemia is due to an iron deficiency. Instead of being given a blood transfusion, the patient is given increased iron supplements and may be given medications such as Erythropoietin (EPO) to increase red blood cell production if the case is severe.
- Surgical equipment, such as machines used to recycle the patient’s blood or minimize blood loss.
Example: A man with a severe heart artery blockage undergoes bypass surgery. An intra-operative cell salvage machine, or cell saver, is used during surgery to collect and recycle the patient’s own blood. The machine collects, washes and separates the red blood cells and plasma and returns them to his body through an IV line.
- Innovative techniques, including minimally invasive surgery, using smaller incisions, reducing blood loss and speeding up the recovery process.
Example: A woman with severe gallstones needs her gall bladder removed. A specially trained surgeon makes a few half-inch incisions in the lower abdomen to remove the gall bladder, resulting in very little blood loss.
Why the bloodless approach makes sense
Through better blood management, doctors can often help the patient avoid the risk of complications after a transfusion. Indeed, bloodless medicine also helps conserve precious donor blood that might be needed in an emergency.
“A large percentage of the blood transfusions in this country are deemed unnecessary,” Gilmores states. A blood transfusion is comparable to an organ transplant. The body can sometimes react by rejecting it or temporarily suppressing the recipient’s immune system.” Other benefits include:
- Lower risk of developing complications or infections from donor blood
- Less time spent in the hospital recovering since the body isn’t adjusting to donor blood
- Fewer concerns about whether blood will be available on the day of the surgery
If you’re interested in bloodless services at Beth Israel Medical Center, you can meet with Sandra Gilmore to review the alternatives, fill out the appropriate legal documents and get answers to other questions. These documents become a part of your electronic medical record so your entire clinical team is aware of your choices.
You have options. Learn more about blood management and bloodless treatment options by visiting chpnyc.org or calling 1-855-411LWNY (5969).
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