Harvard Heart Letter

Transfusion and heart surgery: Only when needed

Unnecessary blood transfusion can do more harm than good.

Blood transfusion deserves a prominent place in the pantheon of medical advances. It has saved countless lives on the battlefield and in hospital emergency departments. It is a life-prolonging treatment for people with conditions that prevent the body from making blood or blood components, from kidney disease and cancer to disorders such as hemophilia and sickle cell anemia. But whether blood should be routinely transfused during or after heart surgery is a question that more and more people are asking. The answer is tilting toward "no."

Questioning 30/10

The theory behind transfusing blood during and after coronary artery bypass grafting, heart valve repair or replacement, aortic aneurysm repair, or other cardiovascular surgery makes perfect sense. Loss of blood during an operation depletes the number of oxygen-delivering red blood cells in circulation. That could mean less oxygen available to tissues throughout the body, especially to surgically traumatized heart muscle.

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