EXTRACTS FROM OPINION, DATED FEBRUARY 9, 2024:
“Blood conservation has been a major initiative throughout those years in our division. We have the most robust JW transfusion-free practice in the world with large cohorts of liver, kidney and pediatric liver transplantations as well as complex liver and pancreatic resections.”
“As the concept of transfusion avoidance matured and gained acceptance
within our own program, we expanded its scope to include more difficult cases
across all service lines. To date, our transfusion-free JW program has over 2500
complex cases performed in JW without major blood products. These include
adult and pediatric heart, liver, kidney transplantations and complex tertiary
surgeries. Segments of this data have been published and a comprehensive
publication is in progress. Results have been equal or superior to those outcomes
in non-JW patients for comparable patient types. …
Serendipitously, this platform for JW-specific care has found a secular home in patient blood management (PBM) for non-Witness patients. PBM has arisen out of the medically proven benefits of transfusion avoidance, not upon religious grounds, but for safety and cost reasons. The past three decades have seen countless publications about the benefits of transfusion avoidance. These relate to morbidities & mortalities which are demonstrably higher when patients receive allogeneic blood products1. Other outcome measures include infection rates, organ insufficiencies, tumor recurrences, and premature deaths. The major driver of transfusion-related morbidities is a phenomenon called TRIM, Transfusion-Related Immunomodulation, and is not related to the safety of blood banking, but rather is inherent in immune mechanisms against foreign substances from blood products administered from a donor source. Thus, the JW resistance to transfusion on religious grounds has logical foundation in the scientific literature as well. …
In the United States the direction and oversight of medicine is moving to embrace blood conservation practice. … On the cost accounting side of the equation lengths of stay, complication rates, and product costs are much more favorable in a transfusion-avoidance population. Thoughtful blood conservation is important for all patients- for their own health and for institutional success.”
“My final comment would be that safe medical/surgical care and the Jehovah’s Witness faith are not mutually exclusive. Recent scientific awareness related to the negative impact of blood product transfusion combined with advances in applied surgical-medical technology make transfusion-avoidance the most sensible choice for a favorable outcome in any patient cohort. The only barrier that remains to broad adoption of a transfusion-avoidance practice is the closed-mindedness of medical practitioners who seem incapable of learning and adopting transfusion avoidance strategies.” (Original in English.)