 |
|
Transfusion-free surgical program reduced use of blood products for all liver transplant patients
September 19, 2006Development of a transfusion-free surgical program for Jehovah's Witness patients undergoing liver transplantation also has helped reduce the overall use of blood products for non-Jehovah's Witnesses undergoing the procedure, according to a study in the September issue of Archives of Surgery, one of the JAMA/Archives journals.
"Orthotopic liver transplantation [in which a patient's diseased liver is removed and a donor liver transplanted into the same place] is typically associated with a large volume of blood loss, resulting in multiple transfusions and related complications," the authors describe in background information in the article. "Transfusion-free surgery is rapidly gaining much-needed attention primarily because of the concerns surrounding transmission of diseases such as human immunodeficiency virus, hepatitis C and other viral infections. Additionally, long-term shortage of blood products and a paucity of alternatives put the system under duress, resulting in cancellation or postponement of elective cases."
Nicolas Jabbour, M.D., from the INTEGRIS Baptist Medical Center, Oklahoma City, and colleagues analyzed the medical records of 365 adult and pediatric orthotopic liver transplants performed from January 1997 through December 2004 at the University of Southern California-University Hospital in Los Angeles. The investigators evaluated the impact of the initiation of a transfusion-free program for Jehovah's Witnesses undergoing liver transplantation on the overall use of blood products in non-Jehovah's Witnesses undergoing the procedure. The pediatric and Jehovah's Witness transplant recipients were eliminated from the study, leaving only adult non-Jehovah's Witness patients who either received a liver transplant from a deceased donor or a living donor (n=272). These patients were categorized into two groups based on the initiation of the Transfusion-Free Medicine and Surgery Program at USC (for Jehovah's Witnesses) in January 2000. Group 1 consisted of recipients who received the liver transplant before January 2000 and group 2 included all patients who underwent transplantation after January 2000.
"Recipients in group 1 underwent orthotopic liver transplants without intraoperative blood-saving or salvaging techniques, whereas all transplant recipients in group 2 underwent intraoperative cell salvage (ICS) and acute normovolemic hemodilution (ANH) whenever feasible," the authors report. "ANH indicates a therapeutic initiative that involves simultaneously removing the patient's blood and replacing it with nonblood products"
"In comparing group 2 with group 1, the mean (average) MELD [model of end-stage liver disease] score was statistically significantly higher, whereas the mean number of intraoperative PRBC (packed red blood cells) and FFP (fresh frozen plasma) transfusions were significantly lower," the authors report. The MELD score describes the survival probability of a patient with end-stage liver disease, with higher scores indicating sicker patients. "The number of preoperative and postoperative PRBC, FFP and platelet transfusions between the two groups was not statistically different."
"The development of a transfusion-free surgical program for Jehovah's Witness patients has had a positive impact on reducing the overall blood use in non-Jehovah's Witness patients," the authors note. According to the authors, autotransfusion decreases some of the complications of transfusions, such as transmission of unknown pathogens, and also helps to preserve blood bank resources, which consequently reduces the overall procedure cost. "Surgeons are the leading consumers of blood products, and it is important that we are leaders in promoting transfusion-free techniques. In conclusion, we propose that the recognized need to minimize the use of blood products be elevated to the same level as antibiotic and deep venous thrombosis prophylaxis (prevention)."
JAMA and Archives Journals
"Recipients in group 1 underwent orthotopic liver transplants without intraoperative blood-saving or salvaging techniques, whereas all transplant recipients in group 2 underwent intraoperative cell salvage (ICS) and acute normovolemic hemodilution (ANH) whenever feasible," the authors report. "ANH indicates a therapeutic initiative that involves simultaneously removing the patient's blood and replacing it with nonblood products"
"In comparing group 2 with group 1, the mean (average) MELD [model of end-stage liver disease] score was statistically significantly higher, whereas the mean number of intraoperative PRBC (packed red blood cells) and FFP (fresh frozen plasma) transfusions were significantly lower," the authors report. The MELD score describes the survival probability of a patient with end-stage liver disease, with higher scores indicating sicker patients. "The number of preoperative and postoperative PRBC, FFP and platelet transfusions between the two groups was not statistically different."
"The development of a transfusion-free surgical program for Jehovah's Witness patients has had a positive impact on reducing the overall blood use in non-Jehovah's Witness patients," the authors note. According to the authors, autotransfusion decreases some of the complications of transfusions, such as transmission of unknown pathogens, and also helps to preserve blood bank resources, which consequently reduces the overall procedure cost. "Surgeons are the leading consumers of blood products, and it is important that we are leaders in promoting transfusion-free techniques. In conclusion, we propose that the recognized need to minimize the use of blood products be elevated to the same level as antibiotic and deep venous thrombosis prophylaxis (prevention)."
JAMA and Archives Journals
Transfusion Current Events and Transfusion News RSSBetter blood screening process needed to prevent babesiosis transmission
Babesiosis is a potentially dangerous parasitic disease transmitted by ticks and is common in the Northeast and the upper Midwest. Babesia lives inside of red blood cells, meaning it can also be transmitted through a blood transfusion from an infected but otherwise asymptomatic blood donor.
Study dispels myth that new residents cause increase in medical errors in July
New research published in the September issue of the Journal of the American College of Surgeons challenges the widely held belief that more medical errors occur in teaching hospitals during the month of July due to the influx of new graduates from medical and nursing schools - also known as the "July Phenomenon."
Resident duty-hour reform associated with increased complication rate
A new study finds a 2003 reform of the length of resident on-duty hours has led to an increase in the rate of perioperative (the span of all three phases of surgery: before, during and after) complications for patients treated for hip fractures.
Interventional radiology treatment for uterine fibroids: Safe, nonsurgical option
Uterine fibroid embolization-a minimally invasive interventional radiology treatment for women that cuts off blood flow to painful fibroids to kill the tumors-is highlighted as an appropriate treatment for women in a Clinical Therapeutics article in the Aug. 13 issue of the New England Journal of Medicine.
Potential risk identified in transfusions of platelets before bone marrow transplant
Research on blood transfusions points to a potential risk of transfusing donated platelets, especially to patients with bone marrow failure syndromes who are subsequently candidates for bone marrow transplantation.
Blood transfusion study: Less is more
A new study suggests that blood transfusions for hospitalized cardiac patients should be a last resort because they double the risk of infection and increase by four times the risk of death.
Hepatitis C infection: treatment options equally effective, likelihood of success known early on
Results of a long-awaited study of 3,070 American adults at Johns Hopkins and 118 other U.S. medical centers show that treatment with either of the two standard antiviral drug therapies is safe and offers the best way for people infected with hepatitis C to prevent liver scarring, organ failure and death.
Pre-chewed food could transmit HIV
Researchers have uncovered the first cases in which HIV almost certainly was transmitted from mothers or other caregivers to children through pre-chewed food.
Serum bile acid profiling for inflammatory bowel disease characterization
Based on serum bank material, BA profiling was applied in IBD patients and healthy controls which showed that most but not all BA species were decreased to a different extent in CD and UC.
Johns Hopkins leads first 16-patient, multicenter 'domino donor' kidney transplant
Surgical teams at The Johns Hopkins Hospital, Barnes-Jewish Hospital in St. Louis, INTEGRIS Baptist Medical Center in Oklahoma City and Henry Ford Hospital in Detroit successfully completed the first eight-way, multihospital, domino kidney transplant.
More Transfusion Current Events and Transfusion News Articles
 |
Essentials of Transfusion Medicine by Fred V. Plapp MD PhD (Author) Essentials of Transfusion Medicine is a concise, but comprehensive, review of all aspects of transfusion medicine including blood donation, blood typing, compatibility testing, blood administration, transfusion therapy guidelines and management of transfusion reactions. Detailed guidelines are also presented for treatment of special clinical situations such as hemolytic anemia, thrombocytopenia, bone marrow and peripheral blood stem cell transplants and coagulation factor deficiencies. This book serves as a readily accessible source of the information needed in the daily practice of transfusion medicine. |
 |
Automaton Transfusion Starring: Juliet Reeves Directed By: Steven C. Miller Three teens find themselves in a town over run with zombies. Deciding to fight back, they go on a punch you in the throat, action packed, non-stop ride through the swamps, forests, blood and ZOMBIES! |
 |
Transfusion by Cold Blood, Lydia Pense Cold Blood was originally signed in 1969 by Bill Graham to his own label and went on to record six albums before disbanding in the late 1970s. The band was revived in the late 1980s and the current lineup started to coalesce in the mid-‘90s under the direction of guitarist Steve Dunne, which culminated in a triumphant return to the Fillmore in 1998. In 2001, DIG Music released Vintage Blood: Live! 1973, a previously unreleased powerhouse collection of songs including their signature version of "You Got Me Hummin’," recorded in an intimate studio setting before a live audience.At the same time, former Cold Blood member Skip Mesquite, who had a number of songs he’d written and thought would be well- suited for Lydia, came in contact with DIG Music. Armed with these great new... |
|
Gazette De La Transfusion by Hopital St Antoine/Hdj Hemato | |
 |
Transfusion Commander Cody (Primary Contributor) |
 |
Blood Banking and Transfusion Medicine: Basic Principles and Practice by Christopher D. Hillyer MD (Author), Leslie E. Silberstein MD (Author), Paul M. Ness MD (Author), Kenneth C. Anderson MD (Author), John D. Roback MD PhD (Author) Ever since the discovery of blood types early in the last century, transfusion medicine has evolved at a breakneck pace. This second edition of Blood Banking and Transfusion Medicine is exactly what you need to keep up. It combines scientific foundations with today's most practical approaches to the specialty. From blood collection and storage to testing and transfusing blood components, and finally cellular engineering, you'll find coverage here that's second to none. New advances in molecular genetics and the scientific mechanisms underlying the field are also covered, with an emphasis on the clinical implications for treatment. Whether you're new to the field or an old pro, this book belongs in your reference library. Integrates scientific foundations with clinical relevance to... |
|
Jazz Transfusion Design Apple iPod touch 2G (2nd Gen) / 3G (3rd Gen) Protector Skin Decal Sticker by MyGift Scratch Resistant Skin Sticker protect and personalize your Apple iPod touch 2nd and 3rd Generation. Self-adhesive plastic-coated skins cover the front and back of the Apple iPod touch 2 Gen and 3 Gen, and they are paper-thin so they do not add any bulk. Skins are easy to apply (no bubbles), durable and easily removable without any residue. When applying the skin, you've got to make sure that the surface is totally clean of any oil or sweat! * This item will not work for iPod Touch 1st Generation. | |
 |
Hoodie Mens Navy Blue " This body needs a Sazerac transfusion " Drinks X-Small by TopExpressions |
|
Transfusion Alternative Health Care, Meeting Patient Needs and Rights Also With: Watchtower (Producer) | |
 |
Stone Age Woo by Nervous Norvus |
| © 2009 BrightSurf.com |