Outstanding Conference on Bloodless Surgery in Moscow
TRANSFUSION ALTERNATIVES IN SURGERY was the name of an international medical conference held in Moscow, Russia, on October 6, 1998. More than 800 doctors were present at the Vishnevskij Institute of Surgery for the symposium, which was held in conjunction with the Sixth All-Russian Congress of Anaesthesiologists and Intensive Care Specialists.
Professor Andrey Ivanovich Vorobiev, who serves as chief hematologist at the Russian Academy of Medical Sciences, in Moscow, welcomed doctors to what he called “this symposium devoted to finding alternatives to the transfusion of blood.”
Describing why the conference was vital, Vorobiev recounted “severe disasters of blood transfusions.” He claimed that as a result of blood transfusions, most hemophiliac children in countries such as the United States, Japan, and Germany have been afflicted with AIDS. Then, after providing statistics on the spread of hepatitis through blood transfusions, he lamented: “The statistics are absolutely amazing. Practically all hemophiliac patients are infected with hepatitis.”
Medical opinion, Vorobiev pointed out, was that if a person “lost a liter of blood, then it should be replaced with a liter of blood.” But “that is a mistake!” he declared. Concluding his opening remarks, he said: “We supported blood transfusion, and now together we shall get rid of the old views.”
Many of the medical experts who followed on the program were from Russia, but there were also speakers from France, Sweden, Belgium, and the United States. Besides describing developments in managing blood loss with alternatives to blood transfusion, the doctors noted the dangers of blood transfusion, including the risk of adverse immunologic reactions.
Television Coverage
Russian public television, which reaches over 235 million people, provided a fine follow-up report about the conference. The moderator, Elena Malysheva, explained: ‘Well-known and internationally renowned surgeons, anesthetists, and hematologists gathered together in Moscow to answer one question: Can surgery be performed without giving blood?’
Elena informed her TV audience of the diseases that can be transferred by blood and explained: “That’s what made the doctors look for a way out. And it was found. It was called bloodless surgery. Every person who is going to have an operation can discuss the methods of bloodless surgery with his or her doctor.”
During Andrey Vorobiev’s appearance on the telecast, he said: ‘Donor blood contains proteins that are alien to the body and can cause unpredictable and inevitable reaction. Additionally, no matter how hard we try, a donor can infect a patient with viruses that he carries and that we are unable to detect.’ So he concluded: ‘We need to reduce transfusion of donor blood to patients.’
Also appearing on the program was Jean-François Baron, head of anesthesiology and intensive care at the Broussais Hospital, in Paris, France. He explained: “In my institution we worked out special liquids that are able to carry oxygen. These all have the oxygen-carrying characteristics of blood but do not contain any red blood cells [which can transmit disease]. In the near future,” he predicted, “these solutions will be used in routine practice.”
This prompted the program moderator to tell about the Russian professor Felix F. Beloyartsev, who introduced an oxygen-carrying liquid as a substitute for blood some 20 years ago. She noted that at the time, Beloyartsev’s discovery was not welcomed by the medical community and that he “committed suicide due to endless persecution caused by this discovery.”
Coverage in Medical Journals
The medical newspaper Meditsinskaya Gazeta also reported on the conference. “The main conclusion of the Symposium,” it said, “can be formulated as follows: It is necessary to use alternatives to blood transfusion in all situations where this is possible and decide for the use of blood only after carefully weighing the level of risk on an individual basis for each patient and only in lifethreatening circumstances.”
The paper also referred to the unwillingness of some doctors to abide by a patient’s refusal to take blood. Jehovah’s Witnesses, for example, do not accept blood transfusions because of the Bible’s instruction to ‘abstain from blood.’ (Acts 15:28, 29) However, regarding this matter, Michel de Guillenchmidt, professor of law from France, was quoted as saying:
‘We should be grateful to Jehovah’s Witnesses because by raising this issue, they have not only drawn attention to their own rights but also helped the entire medical community to understand the dangers of blood transfusions. This, in turn, encourages scientists to look for more sophisticated methods of bloodless surgery.’
One of the articles in Meditsinskaya Gazeta began by saying: “It has been said that transfusion of blood is similar to marriage: No one knows what will follow it.” Then, after noting that ‘human blood is like a man’s fingerprint—there are no two identical prints,’ the paper asked: “Is it possible today to give a full guarantee that the patient will not be subjected to infections as a result of transfusion?” It answered: ‘Even in countries that have achieved impressive results in medicine, there is no effective control system for blood products.’
‘So, judging by the overcrowded auditorium and the clear interest of the delegates in the problems discussed,’ the article concluded, ‘a change in the frame of mind of doctors is taking place.’
Providing a Service
Outside the conference hall, Jehovah’s Witnesses managed a booth at which they provided doctors with a package of articles from medical journals on the use of alternative methods of treating blood loss. Hundreds of doctors gladly accepted these.
Clearly, informed medical professionals are moving toward limiting the use of blood in medicine.
[Pictures on page 26]
Jehovah’s Witnesses provided hundreds of doctors with articles on the latest research on blood