While the majority of orthopedic surgeries are done on an outpatient basis, do not have significant blood loss during surgery and thus do not require blood transfusions, some procedures, such as hip and knee replacement and certain spine surgeries can produce a level of blood loss that may require transfusion.

Many patients, for religious reasons or because of concerns about the risks of blood transfusion, such as allergy, disease transmission and adverse reaction, choose a hospital that offers “bloodless”surgical options (no transfusion of blood products) when they need surgery.

Beth Israel Medical Center and its department of orthopedic surgery has been a pioneer in offering bloodless surgery techniques to its patients. Beth Israel is one of a very few hospitals its size with a formal blood management program in New York State, and has vast expertise in bloodless health care. Because of their expertise in performing bloodless surgery safely, the orthopedic surgeons at Beth Israel have treated bloodless patients from all over the world. At all times, we respect the wishes of our patients who decline blood transfusion as part of their treatment, while still maintaining the highest quality surgical care.

The department of orthopedic surgery employs numerous strategies before, during and after surgery to minimize blood loss and diminish or completely avoid the need for blood products.

• Before surgery
  • Medications, such as erythropoietin (“epo”) and iron are given to maximize red blood counts. Other specialized medications can also be used to increase white cells and platelets
  • Minimizing blood draws and maximizing the use of drawn blood
• During surgery
  • Hypotensive anesthesia, where the patient’s blood pressure is safely lowered during surgery, reduces blood loss
  • Use of minimally invasive and blood-conserving surgical techniques
  • Intravenous medication that can help reduce blood loss
  • Use of a Cell Saver device, which collects blood lost during surgery, washes it and re-infuses it to the patient. This device is a closed system and is acceptable to virtually all patients who request bloodless surgery, even with religious convictions that preclude transfusion.
  • Hemodilution, where blood is drawn in the operating room before surgery, and replaced with intravenous fluids. It is then re-infused to the patient during or after surgery.
• After Surgery
  • Iron is again given to increase red blood cell count
  • Reduced usage of surgical drains
  • Minimized blood draws

If you would like more information about the use of bloodless techniques for your upcoming orthopedic surgery, talk to your surgeon about your options. If you are a Jehovah's Witness and would like a consultation on our bloodless surgery techniques at Beth Israel, please call Sandra Gilmore, Director of the Center for Blood Management, Bloodless Medicine and Surgery at (212) 420-2430.