(Philadelphia, PA) - Transfusion-free cardiac
surgery is now available at the University of Pennsylvania
Health System to anyone who wants it and qualifies as a
good candidate. Patients receive no foreign blood, reducing the
risk of complications and a long hospital stay.
has been available to patients who refused a transfusion due to
religious convictions, but most of the general public is still unaware
this option now exists for them as well,” comments Charles
R. Bridges, MD, ScD, Chief of Cardiothoracic Surgery at
Pennsylvania Hospital and Associate Professor of
Surgery at the University of Pennsylvania School of Medicine.
“Traditionally, heart surgery is associated with the greatest
blood loss of all surgical procedures so it is a technological challenge
to routinely perform open-heart surgery without a transfusion. But
we have a unique combination of skills and a coordinated team that
is not commonly available elsewhere. We have the infrastructure
in place to perform these bloodless surgeries often and well,”
states Bridges. “Not everyone will be a good candidate for
this type of surgery, but I do predict that if patients meet certain
criteria, more than 90% of them will be able to undergo heart surgery
without receiving a blood transfusion.”
PREPPING YOUR OWN BLOOD…
Before surgery, patients see Patricia Ford, MD,
a Hematologist and Director of the Center for Bloodless Medicine
and Surgery at Pennsylvania Hospital, which is certified as a national
bloodless center. She works with patients to prepare their blood
for this option. Ford adds, “We work with our surgical patients
to make sure they’re at their best positioning in terms of
blood count, including their hemoglobin and platelets, for clotting
purposes. We want to make sure their blood parameters are at their
best for the surgery. We can give your body a drug that helps you
to build up blood cells naturally, allowing your body to increase
its blood by about one unit a week.”
Ford further explains that the earlier she sees a patient, the
better the chance of obtaining an optimum level for surgery. “We
prefer to conduct a hemoglobin screening 3-4 weeks before elective
surgery. This transfusion-free option lets you decrease your risk
of side effects or adverse reactions, as well as keep the blood
inside your own body at all times. You can build it up before the
surgery and use the techniques to limit the blood you lose during
In traditional open-heart surgery, on average, one to two units
of blood are used in a typical operation, but a patient could receive
up to seven units. The patient often also receives up to four or
more units of plasma and may receive six or twelve units of platelets.
“The beauty of this option, if you choose it for reasons
other than religious convictions, is that if you have it done, you
can still get a transfusion during surgery to save your life if
it becomes medically necessary,” states Bridges. “However,
by and large, we predict we’d be able to get the vast majority
of these patients through open-heart surgery without requiring any
blood. The patient doesn’t have to worry about contracting
diseases that are transmitted through blood.”
Plus, Ford cautions that even if you store and use your own blood,
there are blood storage issues. Blood cells don’t carry oxygen
as well, can become deformed, and then won’t flow through
your vessels as well once returned to the body. In the approach
that Bridges and Ford use, your blood never leaves your body making
clerical errors virtually impossible and making sure that every
blood cell is working at full capacity at all times.
PATIENTS ARE CHOOSING THIS OPTION…
Irv Shapiro didn’t let anything slow him down, until his heart
valve needed surgery last month. The 60-year-old Mt. Airy, PA resident
-- who has been stepping onto airplanes for decades, traveling all
over the world for his work as an architect -- wanted to get back
on his feet again quickly. He chose to receive a transfusion-free,
minimally invasive heart procedure to fix his heart valve.
walked away, days later, with one small scar. His surgeon, Dr. Charles
Bridges, was able to make a tiny incision on his chest and separate
his ribs gently, avoiding the need to “crack” his chest.
The incision is about two inches long, under the breast crease,
making it almost impossible to detect even by other physicians.
“I never even thought of the bloodless surgery option until
I had my initial meeting with Dr. Bridges and asked him, ‘Should
I give my own blood for the operation?’ He explained the option
and how it was done and it was almost that simple,” said Shapiro.
“It was one less thing to do. I didn’t have to give
any blood to begin with. I was already anxious about making this
repair happen as quickly as possible. I didn’t want a waiting
period for the surgery. I thought, ‘Why not give this a shot!’”
PENN Medicine is a $2.9 billion enterprise
dedicated to the related missions of medical education, biomedical
research, and high-quality patient care. PENN Medicine consists
of the University of Pennsylvania School of Medicine (founded in
1765 as the nation's first medical school) and the University of
Pennsylvania Health System.
Penn's School of Medicine is ranked #2 in the nation for receipt
of NIH research funds; and ranked #3 in the nation in U.S.News &
World Report's most recent ranking of top research-oriented medical
schools. Supporting 1,400 fulltime faculty and 700 students, the
School of Medicine is recognized worldwide for its superior education
and training of the next generation of physician-scientists and
leaders of academic medicine.
The University of Pennsylvania Health System includes three
hospitals [Hospital of the University of Pennsylvania, which is
consistently ranked one of the nation's few "Honor Roll"
hospitals by U.S.News & World Report; Pennsylvania Hospital,
the nation's first hospital; and Penn Presbyterian Medical Center];
a faculty practice plan; a primary-care provider network; two multispecialty
satellite facilities; and home care and hospice.