University of Padua Hosts Landmark Conference to Discuss Advances in Transfusion-Free Medical Care
ROME—On Friday, November 24, 2017, medical, bioethics, and legal professionals convened at the University of Padua, the second-oldest university in Italy, for the conference entitled “The Refusal of Blood Transfusion by Adult Patients: What Are the Treatment Options?—Blood Save 2017.” The conference was sponsored by more than 25 Italian scientific societies and associations as well as Italy’s Ministry of Health.
Dr. Luca P. Weltert
Traditionally, blood transfusions are considered harmless and the only life-saving medical treatment option for patients undergoing complex medical or surgical procedures. This assumption was challenged by many of the conference speakers. One of the visiting experts, Dr. Luca P. Weltert, a cardiothoracic surgeon at the European Hospital, Rome, explained: “We saw today that transfusions can be detrimental and in many cases are not needed.”
Dr. Weltert and other clinicians on the program reached this conclusion based on their clinical experience as well as evidence from scientific studies that establish a correlation between blood transfusions and increased mortality, morbidity, length of hospital stay, and other serious health risks for transfusion recipients. *
“We saw today that transfusions can be detrimental and in many cases are not needed.”—Dr. Luca Weltert, cardiothoracic surgeon, European Hospital, Rome
Such scientific evidence, along with the high cost of blood transfusions, moved the World Health Organization (WHO) in 2010 to identify the need for patient blood management (PBM)—a multidisciplinary and multimodal approach that focuses on health and patient safety, improves clinical outcomes, and significantly reduces the use of blood transfusions. The WHO issued a resolution that urged all 193 member states of the United Nations to implement PBM strategies.
Professor Stefania Vaglio
Professor Stefania Vaglio, chief of transfusion medicine at the Sant’Andrea University Hospital, Rome, discussed at length the new culture of PBM, stating that formerly, medical care was dependent on handling and administering donor blood, but now “the focus has been completely switched from donor blood to a patient’s own blood.” One of the objectives of PBM is “to minimize blood loss by putting the patient at the center of the process, . . . focusing attention and doing all that is necessary in order to preserve the patient’s blood.” Professor Vaglio also clarified that medical techniques to conserve a patient’s own blood “actually mean better quality treatment.”
Dr. Tommaso Campagnaro, a general surgeon at the Verona University Hospital, confirmed the benefits of using strategies to avoid blood transfusions. After completing an analysis of data going back as far as the late 1990s involving patients undergoing the most complex abdominal surgical procedure, he concluded: “The patients who did not receive transfusions had less complications and a lower mortality rate compared to transfused patients.”
“The patients who did not receive transfusions had less complications and a lower mortality rate compared to transfused patients.”—Dr. Tommaso Campagnaro, general surgeon, Verona University Hospital
Associate Professor Anna Aprile
Dr. Campagnaro, along with several other conference speakers, publicly thanked Jehovah’s Witnesses for helping to prompt doctors to develop alternatives to blood transfusions. Anna Aprile, associate professor of medical law at the University of Padua, stated: “We thank Jehovah’s Witnesses, who have raised the issue of the right to refuse transfusions, helping everyone to reflect on this issue and to meet the challenge of using less blood.”
“We thank Jehovah’s Witnesses, who have raised the issue of the right to refuse transfusions . . .”—Anna Aprile, associate professor of medical law, University of Padua
The conference speakers represented diverse medical specialties, such as anesthesiology, cardiology, gynecology, hematology, oncology, and orthopedics. However, the overwhelming message was the same: the medical establishment, lawmakers, and the general public should all be open to PBM strategies in light of the growing body of published data and experiences from experts in the field.
Attendees at the Morgagni lecture hall at the University of Padua listen to one of the presentations.
Dr. Weltert adds: “Aortic dissection repair in contemporary surgical therapy represents the biggest surgery that you can do on a human body. . . . If [this] can be carried out without blood, then really anything can be done.”
Highlights From the Conference
Dr. Tommaso Campagnaro
General surgeon, Verona University Hospital
“Patients who receive blood transfusions are sure to face more complications and problems, as the scientific literature and the statistics indicate. A higher number of blood transfusions correlates with more complications and deaths. So, the association between transfusion and mortality is a reality.”
“In reality, the experience with Witness patients has influenced the treatment methods for all our patients. It has allowed us to make great improvements, and we thank them for that, because as you’ve seen, we’ve been able to reduce significantly the use of blood for all our patients.”
Professor Pia Di Benedetto
Chief of Anesthesiology, Sant’Andrea University Hospital, Rome
“My anesthesiology colleague, Professor Paolo Grossi—who is present today—and I have shared the same view of bloodless surgery for the past 25 years. We both have cooperated with orthopedic surgeons, who were probably the first to agree on our approach to bloodless surgery. . . . So, having worked with them for many years, bloodless surgery has become a reality, a reality that we finally see is beginning to be accepted by everyone.”
Professor Alfredo Guglielmi
Professor of General Surgery, Verona University Hospital
“We have been treating Jehovah’s Witness patients for about 30 years. It has been a very important incentive for us to solve the problems associated with blood transfusions, and not only in relation to Jehovah’s Witnesses.”
Dr. Samuel Mancuso
Conference chairman; cardiac surgeon, University of Turin, Maria Pia Hospital
“The number of patients that refuse blood transfusions for clinical and medical reasons is increasing. Why? It is not only out of concern for transfusion risks but because of the notion that bloodless medicine is better medicine. If I, as a patient, refuse a blood transfusion, I will receive better care, caregivers will prepare me well in advance, everything will be done in a meticulous way, and I will bleed less. If I lose a lot of blood during surgery, doctors will give my blood back to me, and I am guaranteed that they will follow a very strict protocol. Therefore, it is not only Jehovah’s Witness patients who are requesting this kind of [transfusion-free] procedure.”
Dr. Sergio Fucci
Magistrate; former Counselor, Milan Appellate Court; Honorary Chairman, Court of Cassation, Milan
“Medicine should first of all be oriented toward respect for the person and his dignity. . . . I think one of the worst violations of someone’s dignity is not listening to what the person says. It is like denying one the status of being a human.”
Media Contacts:
International: David A. Semonian, Office of Public Information, +1-845-524-3000
Italy: Christian Di Blasio, +39-06-872941
ROME—On Friday, November 24, 2017, medical, bioethics, and legal professionals convened at the University of Padua, the second-oldest university in Italy, for the conference entitled “The Refusal of Blood Transfusion by Adult Patients: What Are the Treatment Options?—Blood Save 2017.” The conference was sponsored by more than 25 Italian scientific societies and associations as well as Italy’s Ministry of Health.
Dr. Luca P. Weltert
Traditionally, blood transfusions are considered harmless and the only life-saving medical treatment option for patients undergoing complex medical or surgical procedures. This assumption was challenged by many of the conference speakers. One of the visiting experts, Dr. Luca P. Weltert, a cardiothoracic surgeon at the European Hospital, Rome, explained: “We saw today that transfusions can be detrimental and in many cases are not needed.”
Dr. Weltert and other clinicians on the program reached this conclusion based on their clinical experience as well as evidence from scientific studies that establish a correlation between blood transfusions and increased mortality, morbidity, length of hospital stay, and other serious health risks for transfusion recipients. *
“We saw today that transfusions can be detrimental and in many cases are not needed.”—Dr. Luca Weltert, cardiothoracic surgeon, European Hospital, Rome
Such scientific evidence, along with the high cost of blood transfusions, moved the World Health Organization (WHO) in 2010 to identify the need for patient blood management (PBM)—a multidisciplinary and multimodal approach that focuses on health and patient safety, improves clinical outcomes, and significantly reduces the use of blood transfusions. The WHO issued a resolution that urged all 193 member states of the United Nations to implement PBM strategies.
Professor Stefania Vaglio
Professor Stefania Vaglio, chief of transfusion medicine at the Sant’Andrea University Hospital, Rome, discussed at length the new culture of PBM, stating that formerly, medical care was dependent on handling and administering donor blood, but now “the focus has been completely switched from donor blood to a patient’s own blood.” One of the objectives of PBM is “to minimize blood loss by putting the patient at the center of the process, . . . focusing attention and doing all that is necessary in order to preserve the patient’s blood.” Professor Vaglio also clarified that medical techniques to conserve a patient’s own blood “actually mean better quality treatment.”
Dr. Tommaso Campagnaro, a general surgeon at the Verona University Hospital, confirmed the benefits of using strategies to avoid blood transfusions. After completing an analysis of data going back as far as the late 1990s involving patients undergoing the most complex abdominal surgical procedure, he concluded: “The patients who did not receive transfusions had less complications and a lower mortality rate compared to transfused patients.”
“The patients who did not receive transfusions had less complications and a lower mortality rate compared to transfused patients.”—Dr. Tommaso Campagnaro, general surgeon, Verona University Hospital
Associate Professor Anna Aprile
Dr. Campagnaro, along with several other conference speakers, publicly thanked Jehovah’s Witnesses for helping to prompt doctors to develop alternatives to blood transfusions. Anna Aprile, associate professor of medical law at the University of Padua, stated: “We thank Jehovah’s Witnesses, who have raised the issue of the right to refuse transfusions, helping everyone to reflect on this issue and to meet the challenge of using less blood.”
“We thank Jehovah’s Witnesses, who have raised the issue of the right to refuse transfusions . . .”—Anna Aprile, associate professor of medical law, University of Padua
The conference speakers represented diverse medical specialties, such as anesthesiology, cardiology, gynecology, hematology, oncology, and orthopedics. However, the overwhelming message was the same: the medical establishment, lawmakers, and the general public should all be open to PBM strategies in light of the growing body of published data and experiences from experts in the field.
Attendees at the Morgagni lecture hall at the University of Padua listen to one of the presentations.
Dr. Weltert adds: “Aortic dissection repair in contemporary surgical therapy represents the biggest surgery that you can do on a human body. . . . If [this] can be carried out without blood, then really anything can be done.”
Highlights From the Conference
Dr. Tommaso Campagnaro
General surgeon, Verona University Hospital
“Patients who receive blood transfusions are sure to face more complications and problems, as the scientific literature and the statistics indicate. A higher number of blood transfusions correlates with more complications and deaths. So, the association between transfusion and mortality is a reality.”
“In reality, the experience with Witness patients has influenced the treatment methods for all our patients. It has allowed us to make great improvements, and we thank them for that, because as you’ve seen, we’ve been able to reduce significantly the use of blood for all our patients.”
Professor Pia Di Benedetto
Chief of Anesthesiology, Sant’Andrea University Hospital, Rome
“My anesthesiology colleague, Professor Paolo Grossi—who is present today—and I have shared the same view of bloodless surgery for the past 25 years. We both have cooperated with orthopedic surgeons, who were probably the first to agree on our approach to bloodless surgery. . . . So, having worked with them for many years, bloodless surgery has become a reality, a reality that we finally see is beginning to be accepted by everyone.”
Professor Alfredo Guglielmi
Professor of General Surgery, Verona University Hospital
“We have been treating Jehovah’s Witness patients for about 30 years. It has been a very important incentive for us to solve the problems associated with blood transfusions, and not only in relation to Jehovah’s Witnesses.”
Dr. Samuel Mancuso
Conference chairman; cardiac surgeon, University of Turin, Maria Pia Hospital
“The number of patients that refuse blood transfusions for clinical and medical reasons is increasing. Why? It is not only out of concern for transfusion risks but because of the notion that bloodless medicine is better medicine. If I, as a patient, refuse a blood transfusion, I will receive better care, caregivers will prepare me well in advance, everything will be done in a meticulous way, and I will bleed less. If I lose a lot of blood during surgery, doctors will give my blood back to me, and I am guaranteed that they will follow a very strict protocol. Therefore, it is not only Jehovah’s Witness patients who are requesting this kind of [transfusion-free] procedure.”
Dr. Sergio Fucci
Magistrate; former Counselor, Milan Appellate Court; Honorary Chairman, Court of Cassation, Milan
“Medicine should first of all be oriented toward respect for the person and his dignity. . . . I think one of the worst violations of someone’s dignity is not listening to what the person says. It is like denying one the status of being a human.”
Media Contacts:
International: David A. Semonian, Office of Public Information, +1-845-524-3000
Italy: Christian Di Blasio, +39-06-872941