Patients who reject transfusions pose challenges to surgeons

Estimated read time: 3-4 minutes

This archived news story is available only for your personal, non-commercial use. Information in the story may be outdated or superseded by additional information. Reading or replaying the story in its archived form does not constitute a republication of the story.

PITTSBURGH (AP) — No matter how desperate the situation, Patricia Hawk won't accept another person's blood in her veins.

Receiving transfused blood could be lifesaving, but it violates Hawk's religious beliefs as a Jehovah's Witness. Blood is sacred and should not be mixed, she said.

"I know it's a commandment from God, so I would be going against him," she said of using foreign blood. "I follow the other high moral commandments, like 'Don't commit adultery.' So I feel that standard is the same with not accepting blood."

Those convictions were put to the test June 4 when Hawk, 64, of Trafford suffered cardiac arrest while climbing a set of stairs at the Cambria County War Memorial during a Jehovah's Witnesses convention in Johnstown.

On-site emergency medical workers revived her by using CPR and a defibrillator and rushed her to Conemaugh Memorial Medical Center in Johnstown.

Hawk carries a medical card in her purse that reads: "We do not accept blood transfusions."

After Conemaugh doctors determined she needed surgery, they flew her by helicopter to Allegheny General Hospital on Pittsburgh's North Side, which has a bloodless surgery center.

Dr. Robert Moraca, a cardiac surgeon at the AGH surgery center, performed a coronary bypass graft. Hawk barely lost any blood, and five days later, she had recovered enough to be released.

Hawk's no-blood preference is rare in medicine. But more patients over the past decade or so have been responding "no" to a question on hospital intake forms about whether they would accept a transfusion if needed, often citing concerns over diseases like HIV, AIDS and hepatitis, said Rita Schwab, program director of bloodless medicine and patient blood management for AGH and also a Jehovah's Witness.

Since establishing its bloodless medicine center in 1998, AGH has worked to reduce transfusions whenever possible, Schwab said. Doctors are learning that patients heal better with their own blood rather than with someone else's and that patients can tolerate anemia better than previously thought, she said.

Like organ transplant patients, transfusion recipients risk rejecting the foreign blood, she said. The techniques can help reduce infections and speed recovery times in all patients, not just those who refuse transfusion, Schwab said.

"Bloodless medicine is kind of a philosophy that has to include everyone who takes care of a patient," said Moraca, AGH's director of thoracic, aortic and arrhythmia surgery.

Surgeons do everything they can to prevent blood loss, Moraca said, and minimize use of intravenous fluids and diuretics that dilute blood.

Schwab said doctors take care to treat any anemia before patients get operations, and they use a "cell salvage" machine that recycles a patient's blood by cleaning it and putting it back into their body.

Moraca treated Hawk when she arrived at the hospital.

Doctors at Conemaugh, where she received initial treatment, had documented blockages in the arteries around her heart that were not amenable to coronary stenting, a procedure to open arteries that is less invasive than surgery, he said.

Moraca used a portion of vein from Hawk's leg and a piece of an artery from her chest to bypass the blockages, with help from a machine that temporarily takes over the functions of the heart and lungs during surgery.

The surgery team performed the same procedures it would have for a regular patient, he said, albeit with the "unique appreciation" that they could not give Hawk a blood transfusion.

"What could be a minor complication could be a life-threatening situation in this subgroup of patients," Moraca said.

"Everything worked out great," said Hawk's husband of 47 years, Mark. "We knew Allegheny General had bloodless medicine here, and they did a fantastic job."

From an expense standpoint, the procedure ultimately was cheaper because no blood had to be used, Patricia Hawk said.

"I feel good," she said. "There's a good crew here. Dr. Moraca saved my life. He did it without blood, and that was it."




Information from: Pittsburgh Tribune-Review,

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Ben Schmitt
    Wes Venteicher-Review


      Catch up on the top news and features from, sent weekly.
      By subscribing, you acknowledge and agree to's Terms of Use and Privacy Policy.

      KSL Weather Forecast