USC Health Now

Q: I heard someone talking about “bloodless surgery” the other day. What does this mean and can it be applied to any surgical procedure?

A: “The basic philosophy of ‘bloodless’ or transfusion-free medicine and surgery is to use every available means to avoid giving patients a blood transfusion [from a donor],” says Rick Selby, M.D., professor of surgery and chief of the division of hepatobiliary/pancreatic surgery and transplant at the Keck School of Medicine of USC. There are many reasons why doctors and patients choose the bloodless or transfusion-free alternative. “Bloodless medicine and surgery can nearly eliminate the risk of contracting diseases related to the donor blood supply,” says Selby. Another risk associated with blood transfusion, he says, is that it might suppress or weaken a patient’s immune system and make them more likely to get an infection. In addition, concerns about blood shortages sometimes lead to cancellation of elective surgeries. Bloodless or transfusion-free medicine and surgeries use a variety of medications, blood conservation and surgical techniques, and special machines to minimize blood loss, says Selby. “Most major surgical procedures can be performed transfusion-free,” he says. “With proper planning and careful management, complex procedures such as open-heart surgery, hip/knee replacements, cancer surgeries and even some liver and kidney transplants can be performed without the use of blood transfusions.”