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Jehovah's Witnesses May Find Way Around Transfusion Ban

Blood substitutes hold hope for those who have been in accidents or need fresh plasma

WEDNESDAY, April 3, 2002 (HealthDayNews) -- Jehovah's Witnesses, whose faith forbids transfusions, may finally benefit from blood substitutes that are in the final stages of clinical trials.

There is still controversy over this issue. Some Jehovah's Witnesses are skeptical of the substitutes, because they are made from hemoglobin taken from red blood cells. But the church doesn't consider the substitutes to be a full-fledged blood product and allows members to use them during surgery. Yet another church faction is campaigning to remove the ban on transfusions altogether.

"It'll clearly save lives if they accept it," said Dr. Ernest Moore, chief of surgery and director of the trauma services at Denver Health Medical Center.

Moore wrote about blood substitutes and Jehovah's Witnesses in tomorrow's issue of the New England Journal of Medicine. In a letter, Moore described the case of a 44-year-old Jehovah's Witness who was in a car accident and needed blood.

Doctors treated the woman with Polyheme, an experimental blood substitute, and erythropolietin, a hormone, which boosts the body's ability to produce red blood cells.

The woman recovered, and the doctors reported that blood substitutes are an "attractive alternative" for Jehovah's Witnesses.

Polyheme is one of several hemoglobin-based blood substitutes that are in the final phase of testing in the United States, Moore said. The hemoglobin is taken from "outdated" red blood cells - stored blood that is no longer fresh - or cells taken from cows.

While they are called blood substitutes, the products are actually substitutes for hemoglobin, a protein that helps blood transfer oxygen to the body, according to Moore.

The substitutes hold special appeal because they don't require testing of blood types, said Dr. Kaaron Benson, director of the blood bank at the H. Lee Moffitt Cancer Center in Tampa, Fla. Emergency-room doctors must often wait to give a transfusion until a patient's blood type is determined; there is a universal blood type, but supplies are limited.

Benson cautioned that the blood substitutes must still be confirmed as safe and easily stored.

Members of the Jehovah's Witness faith follow biblical restrictions on the use of blood. "It's a matter of viewing blood as sacred and then showing respect for it, since it represents life," said Major Spry, associate director of hospital information services for the Jehovah's Witnesses in New York City.

Under church policy, the estimated 1 million Jehovah's Witnesses in the United States cannot accept transfusions of blood or its components -- red blood cells, white blood cells, platelets and plasma.

Some patients have died because of their refusal to accept blood transfusions, and controversy has arisen over whether children should be required to follow the regulations.

In recent years, doctors have developed alternatives to blood transfusions, and Spry estimated that 100 U.S. hospitals now offer "bloodless" surgery.

The church has also allowed members undergoing surgery to take part in "cell salvaging," a kind of blood recycling, and hemodilution, a procedure that temporarily removes blood from the body and replaces it with fluid.

"When a doctor or hospital can use the patient's own blood, that is a safer transfusion," Spry said.

According to Spry, some Jehovah's Witnesses feel the new transfusion methods follow church doctrine because the blood removed from the body is not "spilled" - as in the Bible - but is still "connected" to the body through tubing.

Decisions about the methods lie in the "conscience" of members, he said.

As for the blood substitutes, Spry said some church members may feel comfortable with their use because of a fact of nature -- blood proteins pass naturally from mother to unborn child during pregnancy.

Church dissidents contend that the allowed use of hemoglobin products is proof that the denomination doesn't consistently apply the rules on blood. They are pushing for the blood policy to be discarded, arguing that the Bible doesn't forbid transfusions.

What to Do: To learn more about the policies of the Jehovah's Witness church on blood and blood products, visit the Watchtower.

A dissident group, the Associated Jehovah's Witnesses for Reform on Blood, has its own perspective on transfusions.

SOURCES: Ernest Moore, M.D., chief of surgery, and director of trauma services, Denver Health Medical Center; Kaaron Benson, M.D., director of blood bank services, H. Lee Moffitt Cancer Center, Tampa; Major Spry, associate director, hospital information services, Jehovah's Witnesses, New York City; April 4, 2002, New England Journal of Medicine.
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