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Benefits

As research on bloodless surgery progresses, the list of advantages grows longer. We now know with confidence that avoiding transfusions:

  1. Reduces a patient’s risk of exposure to pathogens that occasionally find their way into the blood supply. These pathogens include bacteria, viruses, prions and parasites. While donated blood in the United States is carefully screened for the hepatitisAIDS/HIV and West Nile viruses and the syphilis bacterium, the infection rate for those diseases is still not zero. Eliminating the use of donated blood eliminates the risk of becoming infected with such diseases by transfusion. (Even reducing blood used in heart surgery to a single unit, and thus a single donor, at least halves the chance of infection.)
  2. Eliminates the risk of triggering a potentially dangerous immune response. A child’s immune system is always on alert for the invasion of alien materials. Immune responses can range from minor inflammation or rash to extreme and even potentially fatal reactions.
  3. Eliminates the risk that a patient will be given the wrong type of blood. Blood mismatches can be caused by minor (and difficult to test for) differences between blood sub-types. Others are due to rare cases of human error. Given the large scale of blood donation and transfusion in the United States, even a tiny error rate can result in units of blood occasionally being mislabeled or inadvertently swapped in the hospital. When this happens, the results can be dire. “It’s great to eliminate even the possibility of such a mistake from the operating room,” says Vamsi Yarlagadda, MD, a cardiovascular intensivist and the co-director of the Bloodless Surgery Program.
  4. Eliminates the risk of overwhelming the patient’s circulatory system by adding too much blood. Known as transfusion-associated circulatory overload, or TACO, this condition is one of the leading causes of transfusion-related death. Because children have so much less blood than adults, the risk of overwhelming their system is greater.
  5. Eliminates the risk of transfusion-related acute lung injury, or TRALI, an immune reaction in which the lungs fill with fluid, potentially causing respiratory failure.
  6. Eliminates the potential medium-term and long-term effects of blood transfusion. These are difficult to study and still not fully understood, but researchers suspect such effects may be as significant as they are for transplant patients.

Minimizing or eliminating dangers associated with surgery is the key to improving outcomes, but there are many other advantages that may also be directly experienced by patients and their families. Pediatric patients who are not exposed to blood products during surgery:

  1. Enjoy shorter stays in the ICU — and in the hospital — after surgery
  2. Spend less time on ventilators after surgery, most likely due to the reduced risk of bronchial infection
  3. Recover more quickly from surgery, possibly because of both the systemic advantages of bloodless surgery and the use of minimally invasive surgical techniques to reduce blood loss