Blood Transfusions - Who Needs Them?

Transfusion refusal while undergoing heart surgery does not increase risk of complications or death

(RxWiki News) Patients who refuse blood transfusions when undergoing heart surgery do not appear to be at an added risk of complications following the procedure.

Researchers examined the risk of complications among Jehovah's Witness patients. Their beliefs do not allow blood transfusions and encourage conserving blood.

"Discuss emergency strategies with your cardiologist prior to surgery."

Gregory Pattakos, MD, MS, a lead author from the Cleveland Clinic, found that both Witness and non-Witness patients had similar risks for dying in the hospital. However, patients who followed the religion were significantly less likely to require additional surgery for bleeding, or experience kidney failure or sepsis, a bloodstream infection.

During the study researchers followed 322 Witness heart surgery patients and 322 cardiac surgery patients who did not follow the faith. The non-Witness patients received blood transfusions.

Investigators found that Witnesses were less likely to suffer complications such as heart attacks, or to require prolonged ventilation. Compared to matched patients who received transfusions, Witnesses also had shorter intensive care unit stays, as well as, briefer overall hospital stays.

One year after surgery 95 percent of Witness patients and 89 percent of transfusion patients were still alive. Survival was similar for both groups at the 20-year mark.

In an invited commentary, Victor A. Ferraris, MD, PhD, from the University of Kentucky Chandler Medical Center, said the findings suggesting that Witnesses might fare better than patients receiving transfusions raises questions about whether more patients could benefit from surgical strategies that minimize blood transfusions.

"The findings of this analysis by Pattakos and colleagues add to the increasing data that suggest that more conservative use of blood transfusions would be in our patients' interest, in both Witnesses and non-Witnesses," Dr. Ferraris said.

The study was recently published in the Archives of Internal Medicine, a publication of the Journal of the American Medical Association.

Review Date: 
July 3, 2012