Bloodless medicine and transplantation

Many patients with leukemia, lymphoma or multiple myeloma have autologous bone marrow transplants (also called stem cell transplants). Transfusions of red blood cells and platelets are often part of the transplant process.

The products for transfusions come from blood donors. But some people can’t or won’t accept blood products due to religious beliefs or personal reasons.

The Penn Medicine Center for Transfusion-Free Medicine offers options for people who decline blood transfusions for any reason.

Some people have religious, personal, medical or ethical reasons for not accepting blood products. Most patients who refuse blood products are Jehovah’s Witnesses. The religion teaches that a person shouldn’t receive another person’s blood, as a sign of respect to God and life.

Others sometimes choose bloodless medicine to avoid the small risks associated with transfusion. Risks associated with receiving live blood cells from another person include allergic reactions and immune problems, leading to infections.

Many other treatment centers won’t perform bone marrow transplants without the option for transfusion. Penn’s bloodless transplant protocol provides an opportunity for lifesaving treatment to patients who might be refused treatment elsewhere.

Penn has developed a special process for safe, effective bone marrow transplants without blood product support. The process is similar to a regular bone marrow transplant, with certain exceptions:

• We respect and understand the reasons you may choose bloodless medicine. Our program employs Jehovah’s Witnesses who serve as coordinators to help you through the process.
• From the first meeting, a specially trained nurse practitioner educates you about the ways the transplant process differs.
• Anemia (low red blood cell count) is a common reason for transfusion. Our team makes sure you have adequate levels of red blood cells and hemoglobin (a protein inside red blood cells). Iron delivered through an IV and medications that stimulate red blood cell development can help prevent anemia.
• Low platelet counts are another common reason for transfusions. Platelets are cells in the blood that assist with clotting. We’ll administer vitamin K and clotting medications to make sure you don’t have bleeding incidents.
• Stem cells used for transplants are often stored in plasma, which is a blood product. Penn and the American Red Cross collaborated to develop plasma-free storage.
• Many patients who seek bloodless treatments must travel great distances, and out of their insurance network. We work with insurance companies early to address possible issues and help you get coverage.
• We’ll work closely and frequently with your cardiologist or one of Penn’s expert cardiologists. It’s important to make sure your heart medications are adjusted as needed to undergo transfusion-free transplant.

Penn Medicine is one of very few bloodless transplant programs in the United States. For those who need bloodless treatment, out program offers:

• Extensive experience: Penn pioneered bloodless medicine options. Our program leader is internationally renowned, teaching other providers how to incorporate bloodless medicine.
• A record of success and safety: We’ve performed hundreds of effective transfusion-free transplants with no major bleeding episodes.
• Treatment for patients turned away elsewhere: Many centers refuse to treat patients who won’t accept transfusion. We welcome these patients and work with them to meet their personal needs and preferences.
• Assistance with financial matters: Our financial coordinator has extensive experience working with insurance companies to get bloodless medicine covered. We can also assist with parking, lodging and food for patients in need, especially those traveling long distances for treatment.