Blood Conservation & Management

Blood Conservation

If you hold religious convictions or have concerns about receiving blood transfusions, you have options. St. Joseph Medical Center is committed to meeting your healthcare needs and to honoring your request for blood management alternatives.

We have a highly trained team of professionals – program director, admitting personnel, nursing staff, pharmacists and physicians – who are dedicated to respecting your request for transfusion-free healthcare. Please speak with anyone involved with your care about your choice not to receive blood or blood products.

Call us at 713.756.8029/866-754-8029 for more information.

Advance Directive

You will be asked to complete a Directive for Non-Blood Medical Management during the registration process. By executing this document you are expressing your desire to participate in the Blood Conservation and Management Program and will not be given blood or blood products not authorized by you or your appointed healthcare agent. Please feel free to speak to the program director if you have questions about the Advance Directive.


Alternatives to blood transfusions include pharmaceutical therapy, blood conservation and a number of surgical techniques from using cauterizing surgical instruments, rather than traditional scalpels, to blood-dilution therapy. Following are some of the pharmaceutical and surgical techniques available to you.

Plasma Protein Fractions

Albumin* — Albumin is a protein formed in the liver and distributed throughout the body by the circulatory system. It is used primarily as a blood vessel volume expander in treating shock. Non-blood volume expanders such as Dextran, saline and ringer’s lactate can be used, but when these fail, albumin may be needed to correct the medical problem.

Erythropoietin — Erythropoietin (EPO) is a synthetic hormone that stimulates red blood cell production in the bone marrow. The major function of red blood cells is to carry oxygen from the lungs to organs and tissues all over the body.Severe blood loss due to surgery, trauma or other medical conditions can reduce the hemoglobin level and affect the red blood cells’ ability to carry oxygen, possibly creating a life-threatening situation. Traditionally, blood transfusion was the management of choice. EPO is a quality alternative. EPO can be used pre- of post-operatively to increase a patient’s own red blood cell count. It is also used to correct anemia.

It must be noted, however, that a small amount of albumin is added to stabilize the ingredients of this preparation.

Immune Globulins* — Immune globulins are proteins found in blood that contains many antibodies. They provide passive immunity to patients exposed to certain diseases such as tetanus and hepatitis. They can also be found in anti-venoms for snake bite victims. Gamma globulin is a similar protein given to pregnant women for Rh incompatibility.

Medical Procedures

Dialysis and Heart-Lung Equipment+ — These procedures are used in cardiac surgery to re-circulate a patient’s own blood (autologous). Blood is directed into a machine that temporarily carries on a function normally handled by body organs. The blood running into the machine is kept in a closed circuit and is directed back into the patient’s body.

Interaoperative Blood Salvage+ “Cell-Saver”  — During surgery, blood is collected from the wound under low vacuum pressure, pumped through a filter to remove debris such as clots, or pumped through a centrifuge to eliminate fluids before directing it back into the patient.When faced with this option, each patient is responsible for talking with the physician about the type of “cell-saver” that will be used. This should be done before making a decision.

Post-operative blood salvage, a similar system, is used for patients who continue to bleed after surgery. In this case, a drain is left in the operative site to capture blood, filter it and return it to the patient.

Acute Normovolemic Hemodilution — This technique can be used in surgeries with a potential for a large amount of blood loss. Just prior to surgery, blood is diluted with non-blood fluids. Blood lost during surgery is in a diluted form and less actual blood is lost. Toward the end of surgery, the blood in the external circuit is returned to the patient.

Tissue Adhesives and Clotting Factors — Tissue adhesives combine the clotting factors Fibrinogen or platelets mixed with thrombin and calcium. They are used in trauma situations, bone repair or surgeries in which specific organs (liver, spleen, pancreas, bones) are losing blood. The mixture is sprayed or painted onto the surgical site to stop or slow blood loss. These products also promote wound healing and re-growth. Tissue adhesives can be commercial preparations derived from pooled human blood products, or they can be made from the patient’s own blood during surgery.Clotting factors are substances in the blood that are essential to the clotting process and to the maintenance of normal hemostasis (arrest of bleeding). Some clotting factors are used to treat hemophiliacs. For patients with religious objections, these products are a matter of conscience.

*The use of minor blood fractions is a matter of conscience for those who do not accept blood transfusions because of religious reasons.

+Some patients have found these procedures acceptable when this equipment is arranged in a closed circuit system.

Learn more about Blood Conservation and Management Services at St. Joseph Medical Center by calling 713.756.8029.

Frequently Asked Questions

What is “transfusion-free” or “bloodless” medicine?
These are terms often affiliated with a Blood Conservation & Management Service. It is an integrated healthcare service available to all patients that utilizes a variety of pharmaceutical therapies and surgical techniques to avoid the use of blood or blood product transfusion. At St. Joseph Medical Center, Blood Conservation and Management Services involves a number of professionals from admission registrars and nurses to pharmacists and surgeons.

Why use Blood Conservation and Management Services?
There are a number of reasons why many patients avoid blood transfusions. Regardless of the reasons, St. Joseph Medical Center is committed to honoring the requests of our patients’ chooses regarding their healthcare.

How can surgery be performed without blood?
A patient’s own blood can be diluted or recycled. Surgeons can use cauterizing instruments rather than tradition scalpels. A number of pharmaceutical therapies are available. Please click on Alternatives to learn more.

Is this program covered by insurance and does it include children?
The Blood Conservation and Management Services Program at St. Joseph Medical Center, is a comprehensive service available to all patients, including children. These services are available at no additional cost to the patient above what is charged for the medical care provided. All patients are given the opportunity to take advantage of this service at the time of their arrival..

What if I am in an accident?
Tell emergency personnel of your wishes concerning the use of blood or blood products, and have your Advance Directive easily accessible. The emergency room staff at St. Joseph Medical Center will coordinate with the director of our program to honor your requests for non-blood medical management..

What if I can’t speak for myself?
Express your wishes to your friends, relatives, co-workers. Sign an Advance Directive and give copies to those close to you. You might carry a card stating your wishes; put it with your driver’s license. We can help you develop an Advance Directive.

What if I change my mind later?
The program is voluntary. You may withdraw your permission and Advance Directive at any time.

Why St. Joseph Medical Center?
We have a team of specially trained staff and physicians in a broad spectrum of medical specialties who are committed to utilizing cutting edge medical alternatives to blood transfusions. We are also the only hospital in the Houston area with a coordinated Blood Conservation and Management Services program. With the addition of this program we are effectively addressing the healthcare needs of patients throughout Houston and across the country.