AABB2025: Bloodless Cardiac Surgery May Be Feasible Option, Following Appropriate Perioperative Protocols

Bloodless cardiac surgery – when appropriate perioperative strategies were used – was associated with outcomes comparable to those of patients who received blood transfusions in conjunction with cardiac surgery, according to results of a meta-analysis presented during the “New Insights to Patient Blood Management” oral abstract session on Saturday afternoon.

The study results, presented by Minh-Ha Tran, DO, from the University of California, Irvine, were based on an analysis of 10 studies examining cardiac surgery in Jehovah’s Witnesses, known for refusing blood transfusions on religious grounds, even when transfusion is considered essential.

Tran and his colleagues assessed the studies’ results for 30-day mortality, kidney injury, and blood loss. The results indicated that bloodless cardiac surgery can be performed safely with modern perioperative care, and that patient outcomes often depend more on perioperative management quality than transfusion itself. When hemoglobin is optimized and bleeding minimized, surgery remains safe without transfusion. The study’s strengths included strict inclusion criteria, PRISMA-compliant meta-analytic statistics, and modern relevance. Limitations involved varying hemoglobin measurement timepoints and inconsistent application of blood management protocols across centers.

Tran said the findings “support the safety and efficacy of blood conservation techniques, not only for Jehovah’s Witnesses, but potentially for broader cardiac surgical populations.”