Tacoma infant saved by pioneering procedure: bloodless open-heart surgery
When Tacoma infant Hermann Ntuadi was born in mid-September, he immediately went into heart failure.
The newborn had a complex heart disease that required surgery - and he needed it soon.
But as Jehovah's Witnesses, the Ntuadi family faced a unique challenge: their religious beliefs prohibit blood transfusion, a procedure that’s considered unavoidable for pediatric heart surgery.
Luckily, they weren’t far from one of the few programs in the nation that could honor their beliefs.
The Seattle Children’s Blood Conservation Program is the largest blood conservation program in the United States, and it’s where the Ntuadis brought Hermann.
The program sees around 600 surgical cases a year and serves patients from Washington, Alaska, Montana and Idaho, program manager Anya Buell said.
Thanks to the expertise of experienced pediatric heart surgeons and pediatric cardiac care specialists, the team developed methods of operating without the need for donated blood.
Due to the small size of babies and young children, they have less blood and are more likely to need supplemental transfusions.
Using a special bypass circuit and a unique way to control bleeding during surgery, most of the program’s patients don’t need a transfusion to replace lost blood.
This type of procedure was an essential lifeline for Hermann, who after half a year in the hospital was discharged last month.
The family was relieved and excited to bring their 5-month-old home, who today is “doing great” said Dr. Lyubomyr Bohuta, who leads the blood conservation team
“This is part of the work to serve our patients better, to improve the experience, to reduce the number of complications and to avoid the unnecessary treatment,” Bohuta said.
Bloodless surgeries don’t just have benefits for religious reasons. For one, skipping the transfusion can preserve limited hospital resources and save families money.
“There’s a national shortage of lab products and resources needed for a variety of treatments,” Bohuta said. “If you can use less and save it for someone who needs it more, that’s fantastic.”
These procedures also mitigate the risks that come with using someone else’s blood.
Transfusions bring the risk of infection from donor sources, allergic reactions to the blood or even the patient’s immune system attacking the donor blood’s red blood cells.
Although the risks of these adverse reactions are low, skipping the transfusion avoids them altogether.
Operating without a blood supply is no easy feat. It’s a high-tech process that involves large teams of multidisciplinary experts and took years of brainstorming.
Today, over 50% of patients who come into the program are not exposed to any blood products during treatment, including operation, Bohuta said. In smaller operations, like those treating atrial and ventricular septal defects, the freedom from need for transfusion is almost 100%.
“What we do is exceptional,” Bohuta said. “We’re pretty much the only [program] in the country who achieved significant success.”
