Friday, Dec. 14, 2001 | 9:36 a.m.
Prompted by Jehovah's Witnesses, Sunrise Hospital and Medical Center administrators are laying the groundwork for Southern Nevada's first "bloodless" medical center.
The center would provide alternative treatments for people who refuse blood transfusions for religious or other reasons. There are more than 50 such centers in the United States, but none in the Las Vegas Valley, said Dr. Brad Karon, a Sunrise physician and member of the hospital's bioethics committee.
"Bloodless medicine" is an attempt to minimize blood loss by using technical and pharmacological means, and by educating physicians to tolerate anemia in their patients more. The goal is to make transfusions unnecessary.
Jehovah's Witnesses do not accept blood transfusions because they believe blood is sacred, and they lobby hospitals worldwide to adopt bloodless procedures.
"In Vegas, it (the effort to establish a center) is definitely being driven by religious communities -- by the Jehovah's Witnesses," Karon said. There are more than 6,500 Jehovah's Witnesses in Southern Nevada.
Karon said the hospital's program will likely include creating a patient refusal-of-transfusion form and a list of physicians who are willing to treat patients with alternative methods, and implementing lab procedures and technologies that use less blood. Sunrise already uses some bloodless procedures, but establishing a center would make such procedures more accessible, Karon said.
Jehovah's Witnesses' refusal to accept transfusions has long been a difficult issue for physicians, who are obligated to try to save lives with all of the tools at their disposal.
But in the past two decades, Witnesses have been joined by hosts of other people who have become hesitant to accept blood transfusions. After the emergence of AIDS and HIV, many people began refusing transfusions for fear of contracting diseases -- although the American Association of Blood Banks says the risk of getting infection through transfusion is extremely slim.
"Still, I get called to the hospital at least once a month to treat a patient who refuses a blood transfusion," Karon said. "What establishing a center would do is give us a formal procedure, a formal policy ...
"In the absence of a policy, the procedure is all manual -- we draw less blood, we ask the lab to work with less blood," Karon said.
"Our goal for next year is to switch the adult intensive care units over to low blood volume laboratory tests," Karon said. "Data is out there that shows you can limit the transfusions by lowering that volume."
Transfusions are most necessary in major surgery, however. Patients who need heart surgery or orthopedic surgery almost always need transfusions, Karon said.
In some bloodless hospitals, such as Tampa General in Tampa, Fla., patients can donate their own blood ahead of surgery, or use a vacuum-like machine that sucks in lost blood, cleans it, and pumps it back in.
Although the technology has been improving for two decades, many major hospitals, such as UCLA Medical Center, have not established bloodless centers.
Sunrise's bioethics committee -- a team of physicians, administrators and clergy who address the hospital's social and moral responsibilities -- has been discussing establishing the bloodless center for more than a year.
"Some doctors are more open to the techniques than others," said Jehovah's Witness Hospital Liaison Committee Chairman Al Zaragoza, who has attended the Sunrise's meetings on the matter.
Although the Jehovah's Witness committee works with other area hospitals, Zaragoza said Sunrise has been most receptive to bloodless work.
University Medical Center Spokesman Rick Plummer said UMC does not have a bloodless program, but does use some of the bloodless procedures when requested.
"We cater to the specific needs of individuals, but we don't have a program in place," Plummer said. In addition to religious beliefs, blood shortages are another reason bloodless procedures are becoming more popular, Plummer said.
"I think that's the direction health care needs to go," Plummer said.
More than 1,400 Jehovah's Witness Hospital Liaison Committees work with hospital staffs across the world.
"It's a biblical stand that we take," Zaragoza said. "We refuse white blood cells, red blood cells, plasma, and platelets -- we refuse whole blood."
Witnesses' belief that blood is sacred is rooted in Leviticus 17:14, "You must not eat the blood of any creature, because the life of every creature is its blood; anyone who eats it must be cut off."
Additionally, they cite Acts 15:29, "You are to abstain from food sacrificed to idols, from blood, from the meat of strangled animals and from sexual immorality."
Karon said that bloodless procedures cost roughly the same as transfusion procedures, and that establishing the center would mean shifting costs, not adding additional expenses to the hospital.
"We hope to have a policy in place within two months," Karon said.
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