Transfusion-Free Medicine and Surgery

This book aims to be a guide to the practice of blood conservation. The first chapter discusses the legal and administrative aspects of bloodless medicine describing the legal principles and practical issues relatd to refusal of transfusion. The second is on balancing the risks and benefits of transfusion includes clinical vignettes of appropriate and inappropriate transfusion. The remainder of the book covers the principles and practice of bloodless medicine, including a chapter on the scientific issues of haemostasis and the investigation of bleeding idsorders. The book concludes with chapters on blood conservation in neonatal and paediatric surgery, the costs associated with blood transfusion and the quest for artifical blood. New chapters will be included to address blood utilization in oncology and geriatric patients.

Nicolas Jabbour, MD, FACS, Medical Director, Nazih Zuhdi Transplant Institute at INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma, USA
Dr Jabbour performs live donor liver transplantation, hepatobiliary/pancreatic and liver surgery. Previously, he was the Associate Director of Multi-organ Abdominal Transplantation, Director of Transfusion-free Medicine and Surgery and Associate Professor of Surgery at the USC Keck School of Medicine. He was also an attending staff member at Los Angeles County USC Medical Center, the Norris Cancer Hospital and the Children's Hospital of Los Angeles.
Dr Jabbour earned his undergraduate degree with the highest distinction at the Facultes Notre Dame de la Paix in Namur, Belgium, and his M.D. with the highest distinction at the Universitaires Libre de Bruxelles in Brussels, Belgium. After graduating, he completed his internship at Brugmann University Hospital under the auspices of the Universite Libre de Bruxelles. His residencies were completed at Lincoln Hospital and Our Lady of Mercy Hospital under the auspices of New York Medical College in New York City. His fellowship in transplantation surgery was conducted at the University of Pittsburgh and Children's Hospital of Pittsburgh under the direction of Dr. Thomas E Starzl. He is board certified in both general surgery and surgical critical care and certified transplant surgeon from the University of Pittsburgh.
Dr Jabbour was one of the team leaders who performed the world's first bloodless live donor liver transplantation in adult and pediatric Jehovah’s Witness patients, and who initiated adult to adult live donor liver transplantation in the west coast. Dr. Jabbour’s research interests include living related liver transplantation and innovative liver monitoring.

Contributors, ix

Preface, xiii

1 History of blood transfusion and patient blood management, 1
Shannon L. Farmer, James Isbister, and Michael F. Leahy

2 The ethical complexities of transfusion-free medicine, surgery and research, 19
Katrina A. Bramstedt

3 Transfusion therapy – Balancing the risks and benefits, 28
Irina Maramica and Ira A. Shulman

4 The physiology of anemia and the threshold for blood transfusion, 61
Senthil G. Krishna, Ahsan Syed, Jason Bryant, and Joseph D. Tobias

5 Blood transfusion in surgery, 83
Sharad Sharma, Lance W Griffin, and Nicolas Jabbour

6 Current view of coagulation system, 102
Yoogoo Kang and Elia Elia

7 Topical hemostatic agents, 143
Fabrizio Di Benedetto and Giuseppe Tarantino

8 Intraoperative strategies for transfusion-free medicine, 158
Joseph D. Tobias

9 Post-operative management in transfusion-free medicine and surgery in the ICU, 207
Jean-Louis Vincent

10 The changing transfusion practice of neonatal and pediatric surgery, 222
Pamela J. Kling and Nicolas Jabbour

11 Current management of anemia in oncology, 247
Shelly Sharma and Sharad Sharma

12 Artificial blood, 271
Aryeh Shander, Mazyar Javidroozi, and Seth Perelman

13 Translational strategies to minimize transfusion requirement in liver surgery and transplantation: Targeting ischemia-reperfusion injury, 289
Reza F. Saidi and S. Kamran Hejazi Kenari

14 Legal and administrative issues related to transfusion-free medicine and surgery programs, 315
Randy Henderson and Nicolas Jabbour

15 Basic principles of bloodless medicine and surgery, 338
Nicolas Jabbour

Index, 347

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