IJN takes on 'no blood transfusion' op challenge

NST: KUALA LUMPUR: A groundbreaking open-heart surgery is scheduled to take place at the National Heart Institute (IJN) on Jan 29. The procedure will be a first locally — because it will be without any blood transfusion.
It is being done at the request of a 59-year-old retiree from Setapak. The request is based on religious grounds.
An eight-member team, including three surgeons and an anaesthetist, headed by consultant cardiothoracic surgeon Dr Pau Kiew Kong, will perform the five-hour operation.
"We won’t give him any blood product. It’s going to be heart surgery without blood," Dr Pau said.
He said many cardiac surgeons would not carry out such surgery because of the cutting and suturing of the heart.
This is why the "safety net" of blood transfusion is always practised in major surgery.
Dr Pau said heart surgery without blood transfusions was quite safe if carried out properly.
Risks remain but precautions would be taken before, during and after the surgery, he said.
It’s learnt that IJN had carried out two or three minor surgeries without blood transfusions 10 years ago following requests from patients.
Dr Pau said the patient’s blood needed to be increased via drugs prior to surgery.
Iron supplements and folic acid usually do the trick.
Dr Pau said erythropoietin stimulated the bone marrow into producing red-blood cells, increasing the haemoglobin of patients. "This starts at least 10 days before surgery."
Drugs would also be administered to reduce blood loss during surgery.
"We will also recycle blood during surgery using the cell-saver technique. This ‘cleans’ all blood lost during surgery before it is returned to the patient."
He said tissue glue can also greatly reduce "micro-bleeding" during cardiac surgery.
Asked what would be done if a blood transfusion proved necessary during surgery, he said the patient’s wishes would be respected. The patient is required to sign a "no blood" consent form.