Types of Transfusion-Free Surgeries

Advances in the field of transfusion-free medicine have helped increase the types of surgeries that can be done using transfusion-free, or “bloodless,” techniques. At Keck Medicine, we can deliver transfusion-free services for the following procedures:

• Cardiothoracic surgery
• Colorectal surgery
• General surgery
• Gynecologic surgeries
• Head and neck surgery
• Hepatobiliary and pancreatic surgery
• Neurosurgery
• Oncologic surgery
• Orthopedics
• Spine surgery
• Urologic surgery
• Vascular surgery

Transfusion-Free Techniques

If you request transfusion-free services, the following practices and techniques may be used as part of your care:

• Blood augmentation — This is a pre-operative procedure to maximize your red blood cells. This is done by using iron and the natural human hormone erythropoietin to help increase the production of red blood cells by your bone marrow.
• Blood conservation — During surgery, surgeons use blood conservation techniques like Intra-operative Cell Salvage (ICS) and Acute Normovolemic Hemodilution (ANH). These are ways to collect, wash, filter and return blood back to the patient.
• Minimal lab testing — After a procedure, your care team tries to minimize the amount of blood work you need for lab testing.

How Do I Get Transfusion-Free Care?

We are dedicated to making our innovative transfusion-free surgery and blood conservation techniques available to you. Our services are broken into two main options:

1. Transfusion-Free Services (TFS) program:

• This program is primarily for Jehovah’s Witness patients whose religious beliefs do not permit the use of blood transfusions or blood products, such as red cells, white cells, platelets and plasma.
• This care option requires a formal consent process and legal agreement between you, the patient, and your care team. In this agreement, you specify which blood products and techniques may or may not be used in your care.
• Your doctors, surgeons, anesthesiologists and clinicians follow the care terms outlined in the legal agreement.

2. Patient Blood Management (PBM) Program:

• This program is available to any patient who wants limited use of blood transfusions or blood products, generally due to health-related concerns.
• This care option does not have a formal legal consent process like the TFS program.
• You must meet with your surgeon and discuss the available blood conservation and blood transfusion alternatives before treatment.

How to Sign Up

To get started with transfusion-free care, please contact our team at (323) 442-5261 or TFSPBMinfo@med.usc.edu.

Frequently Asked Questions

What is transfusion-free medicine?

Transfusion-free medicine and surgery is designed to help people who choose not to receive blood transfusions or blood products as part of their medical and/or surgical care. Doctors and surgeons who offer transfusion-free care are highly trained and use specialized techniques and equipment.

How does transfusion-free medicine work?

The primary goal of transfusion-free medicine and surgery is to minimize blood loss for the patient. This is done by using a variety of medications, blood conservation, blood filtration, specific surgical techniques, and special surgical tools and machines.

In most cases, one or more of the following procedures may be used to perform a transfusion-free, or “bloodless,” surgery:

• The patient’s blood may be filtered through a specialized device called a cell-saver. During surgery, blood that is lost is usually disposed of with other fluids. However, by using the cell-saver machine a surgeon can collect, wash, filter and return this blood back to the patient.
• Surgeons use surgical instruments that use an electrical current to cut tissue and seal blood vessels. This helps prevent blood loss.
• Medicines, such as erythropoietin, can be used to naturally stimulate the bone marrow to make more red blood cells.
• Patients take certain medications to help blood clot properly. This medicine helps prevent excessive bleeding during and after surgery.
• Anesthesiologists can use normal saline solution or other intravenous solutions to perform blood-dilution techniques to conserve blood during surgery. They can also lower a patient’s blood pressure and temperature to reduce the possibility of major bleeding.

Who uses transfusion-free services?

Transfusion-free medical and surgical care is often requested by patients who wish to avoid blood transfusions due to their religious convictions.

This specialized care is also requested by patients with non-religious concerns, such as:

• Blood supply availability
• Blood transfusion costs
• Exposure to blood-borne diseases
• Healing and recovery

Our program offers transfusion-free treatment options for both religious- and non-religious-based needs.

What surgical procedures can be done with transfusion-free techniques at Keck Medicine of USC?

At Keck Medicine, surgical procedures that may be done with limited or no blood transfusions include:

• Cardiothoracic surgery
• Colorectal surgery
• General surgery
• Gynecologic surgeries
• Head and neck surgery
• Hepatobiliary and pancreatic surgery
• Neurosurgery
• Oncologic surgery
• Orthopedics
• Spine surgery
• Urologic surgery
• Vascular surgery

Is transfusion-free medicine safe?

There are some risks associated with any medical procedure, including transfusion-free therapy. Talk to your doctor to learn more about the potential risks and benefits of transfusion-free, or “bloodless,” procedures.