Correct Pre-Op Anemia to Limit Transfusions. (Lessons From Jehovah's Witnesses).

ORLANDO, FLA. -- Patients receive far more transfusions than necessary, a trend that can be reversed if physicians make a concerted effort to identify and correct preoperative anemia and take advantage of various strategies to minimize the use of donor blood, Dr. Arnold Friedman said at a meeting of the One Kilo Club.

"Blood transfusion is bad. Let's all assume we can agree on that," said Dr. Friedman, chairman of obstetrics and gynecology at Beth Israel Medical Center in Manhattan.

When patients are transfused, they can be exposed to contaminants and viruses. Even patients who store autologous blood can be given the wrong units. Autologous blood donation can make patients anemic who weren't anemic before. What's more, reinfused blood, whether autologous or donated, does not oxygenate tissues as efficiently as the patient's undisturbed blood.

Dr. Friedman became interested in reducing blood loss during surgery while he was at Englewood (N.J.) Hospital and Medical Center, site of the largest bloodless medicine and surgery institute in the world. The center, initially founded to meet the needs of the Jehovah's Witnesses, a religious group opposed to blood transfusions, provided lessons that could be applied to all patients, he explained.

"Patients tolerate anemia. In fact, they tolerate anemia much better than physicians tolerate anemia," he said.

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