Hospital Liaison Committee Handout on Blood Fractions (2000)

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JEHOVAH'S WITNESSES MEDICAL ALTERNATIVES TO BLOOD

1.

NOT ACCEPTABLE

Whole Blood

Packed Red Blood Cells

Platelets

Plasma

White Blood Cells

Autotransfusion of predeposited blood Any technique that involves blood storage

2.

ACCEPTABLE ALTERNATIVES

Blood-Oxygen Monitoring Devices:

Transcutaneous Pulse Oximeter Pediatric ultra-microsampling equipment Multiple tests per blood draw [batching]

Hematopoietic Agents:

Iron Dextran (Ferrlecit, Infed, Venofer [IV-form])

Folic Acid

Vitamin B-12

Vitamin C

Granulocyte-Colony Stimulating Factor (Neupogen)

Interleukin-II (Neumega)

Antibolic Androgenic Hormones

Recombinant Stem-Cell Factor (Stemgen)

Hemostatic Agents to Promote Clotting:

Topical: Avitene, Gelfoam, Oxycel, Surgicel Injectable: Desmopressin (DDAVP), e-aminocaproic acid (Amicar) Tranexamic acid (Cyklokapron) Vasopressin (Pitressin), conjugated estrogens, Aprotinin (Trasylol) Vincristine (Oncovin) Vitamin K (Phytonadione)

Operative & Anesthetic Techniques for Surgery:

Hypotensive Anesthesia Induced Hypothermia Mechanical occlusion of bleeding vessel

Oxygen Therapy:

Hyperbaric Oxygen

Perfluorocarbon Solutions

Recombinant Antihemophilic Factors:

Recombinant Factor VIIa (NovoSeven) \circledR

Recombinant Factor VIII (ReFacto)

Recombinant Factor IX (BeneFIX)

Surgical Devices & Techniques:

Electrocautery Laser Surgery Argon Beam Coagulator Gamma Knife Radiosurgery Microwave Coagulating Scalpel Endoscope Arterial Embolization Ultrasonic Scalpels Cryosurgery Minimally Invasive Surgery

Volume Expanders:

Crystalloids: Ringers' Lactate, Normal and Hypertonic Saline

Colloids: Dextran, Gelatin, Hetastarch. (Hespan, Hextend, Pentastarch)

Important note: All product names listed here are for identification purposes only. This sheet does not constitute an endorsement or promotion.

PERSONAL DECISION

Medical Products & Therapy;

Albumin

Cryoprecipitate (contains small amt. of plasma)

√EPO-Erythropoietin (contains small amt. of albumin)

Hemoglobin-based blood substitutes

√ Hemophiliac preparations (non-synthetic)

Immune Globulins

√Interferon (natural & synthetic buffered with albumin)

Plasma Protein Fraction (Plasmanate)

Organ transplants and donations

Tissue adhesives

Wound healing factors (platelet deriv.

Medical Test: Red & white blood cell tagging

Recombinant Antihemophilic Factors: Recombinant Factor VIII (Kogenate - small aml. of albumin)

Surgical Procedures (non-blood primed & no storage):

√Dialysis & heart-lung equipment

√Hemodilution

√Intraoperative & postoperative blood salvage (cell saver)

√Therapeutic Ap resis