San Antonio Hospital Aims to Perform "Bloodless" Surgeries

For Blood / Biologics

Northeast Baptist Hospital in San Antonio, Texas has adopted a perioperative blood management program, aiming to perform 90% of surgeries without blood transfusions. The hospital has received support from the South Texas Blood & Tissue Center, which says bloodless facilities help ease the demand for blood and tissue donations.

Blood transfusions are standard practice during many surgeries, but now a local hospital says it can do even complicated, open-heart procedures without transfusing blood. It says the surgeries are safe, less expensive and the patients recover faster.

Northeast Baptist Hospital says this is not a medical trial. It is converting the entire hospital into a bloodless facility, with a goal of performing 90% of its surgeries without blood.

How is that possible?

Take the case of Raymond Talbert, who is legally blind, and needs one of his heart valves replaced or he could die.

Talbert cannot receive a blood transfusion because of his religious beliefs. "Because I'm a Jehovah's Witness, I do not take blood, so they recognize that and they respect that so it pleases me immensely."

In the days before the surgery, Talbert's surgeon, Dr. Jerry Kelley, tries to conserve Talbert's own blood by drawing as little of it as possible for testing.

"In the past, you would take a big tube of blood," explains Dr. Kelley. "Now, we're using very small tubes and basically, every test that we're ordering now, we're thinking, 'Do we really need this test? Or can we go by the results we had yesterday?'"

Talbert is also given iron and a special drug to build up his blood cell count in advance of the surgery.

"My faith is strong, I have no questions about doing it this way, and the technology is there to do it," says Talbert.

While performing the operation, Dr. Kelley cauterizes blood vessels as he goes, to minimize bleeding. What blood is lost, goes into a special machine called a cell saver, which filters raymond's blood, and routes it directly back into his veins. They also dilute Talbert's blood with a saline solution, to increase the volume of blood in his body.

Bloodless hospitals in other parts of the country have been using these techniques for years.

"This is nothing experimental. These are procedures being done other places," adds Dr. Kelley. "We have data from around the country to support everything we're doing here."

In fact, Northeast Baptist Hospital has the support of the South Texas Blood & Tissue Center, which says bloodless medicine could help reduce demand for donated blood.

"If a hospital can utilize bloodless medicine and reduce usage in elective surgeries, then that helps trauma patients and surgeries that go unscheduled, to be able to have blood available," says Dr. Rachel Beddard with the South Texas Blood & Tissue Center.

Another heart patient, Larry Harber, has no religious objection to blood. The former firefighter is more concerned about possible infections or complications from receiving donated blood.

"You always have that thought, 'I would prefer to keep my own blood, as opposed to have someone else's blood'," says Harber.

Northeast Baptist Hospital hopes by going bloodless, it will no longer have to delay or cancel surgeries due to a shortage of donated blood. And the move could save the hospital hundreds of thousands of dollars a year.

Just one unit of donated blood can cost a hospital more than $700. By the time the hospital matches the blood and does the transfusion, the cost to the patient can jump to $1,500 or more.

"It's cheaper all the way around," says Dr. Kelley. "The hospital bill's going to be less. You have less chance of having a problem with the blood, and you heal faster, you heal better."

That seems to have been the case with Raymond Talbert.

He was able to leave the hospital four days after his heart surgery. Northeast Baptist says other patients who received the same procedure with blood transfusions spent 15 to 22 days in the hospital.

The average cost of a heart surgery without blood is $16,435. With blood transfusions, the same surgery costs $23,415.

"I feel good about it, I feel positive about it, I'm physically well, I'm alive. I'm not doing any marathons today but I'm here," says Talbert.

Doctors will still be able to give a transfusion if they feel it is medically necessary, or if the patient asks for it, but now when a patient first checks in to the hospital they will automatically be told about the benefits of bloodless surgery.

This life science article was provided by WOAI-TV (NBC) San Antonio.