June 27, 2019/Italy - Doctors at Two Major Medical Conferences in Italy Showed Interest in Transfusion-Alternative Strategies - Conclusion

 "The relationship with Jehovah's Witnesses further convinced me of the need for extreme respect that my profession owes to the cultural  and religious convictions of patients. I feel a lot of backing from the recent legislative recognition in Italy with Law 219 of December 2017,  'Provisions for informed consent and advance directives,' where it states that 'no health-care treatment can be initiated or continued without the person's free  and informed  consent.' If the surgeon communicates with the patient in a competent, fee, and responsible  way, there will surely be advantages for both in terms of sharing responsibilities. increasing the degree of freedom, and ultimately a more adequate and effective treatment path." - Luca Ansaloni, director of general and emergency surgery unit at the Bufalini Hospital of Cesena, president of the Italian Society of Surgical Physiopathology (SIFIPAC) 

"Jehovah's Witnesses have greatly contributed to the refinement of treatment  strategies that avoid blood transfusions.  New surgical technologies are instrumental in respecting the will of patients who for religious reasons refuse blood transfusions.  There are definite advantages to the cost-benefit ratio of bloodless medicine.' - Diego Piazza, president of the Italian Medical Association of Catania, director of oncological surgery at the Garibaldi-Nesima Hospital of Catania,  former president of the Italian Association of Hospital Surgeons (ACOI)

"The apparent 'harmless' nature of blood transfusions, their perceived easy availability, their relatively low cost, the ease with which they can be prescribed, the possibility to immediately observe their effectiveness  (in terms of increased  hemoglobin levels) -all these aspects have contributed to their widespread  use. However, the evidence related to the possible harmful effects connected to the transfusions of both concentrated red blood cells and the other blood components has increased each year.  In fact, several studies have shown that transfused patients incur complications more frequently than non-transfused patients  and worse outcomes with increased risk of mortality, morbidity (stroke, renal injury, thromboembolic events, infections, respiratory failure), and prolonged hospitalization.   I think that the treatment of Jehovah's Witness patients over the past 50 years has led clinicians to greater awareness of blood conservation and of the progress of bloodless surgery." -Giandomenico Biancofiore, director  of the complex operative unit of anesthesia and resuscitation in transplants at the Pisa University Hospital, associate professor of anesthesiology and resuscitation at the University of Pisa. 

Next time: Transfusion Medicine-Is Its Future Secure?

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