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Breaking the Borrowed Blood Habit

Hemo Concepts helps wean hospitals from reliance on transfusionsHealth Care

Making blood transfusions a routine part of hospital treatments was a medical milestones of the 20th century. Making them more rare than routine could be a hallmark of the 21st.
Hemo Concepts wants to help with that. The Eatontown company is offering a complete package of educational and consulting services to hospitals around the country that want to reduce their use of donated blood.
The rising cost of donated blood, periodic shortages in supply and the risk that donated blood may harbor diseases that aren?t yet screened for have fueled a growing national movement on behalf of bloodless medicine. The goal of the movement is to find ways to perform surgery and other medical procedures with fewer blood transfusions than in the past.
?We?ve proven that blood is overused and it?s not always indicated as early as some may think,? says Ron Traviglino, director of the New Jersey Institute for Bloodless Medicine and Surgery at Englewood Hospital.
The hospital has emerged over the past decade as a leader in developing treatments that minimize blood loss during surgery. And it has developed ways to treat patients who refuse, on religious or other grounds, to have blood transfusions.
The Englewood program began after the hospital was approached by a group of Jehovah?s Witnesses who wanted to be treated without transfused blood. The sect objects on religious grounds to receiving transfusions but is open to using substitutes and blood saving techniques.
Englewood techniques include reclaiming blood in the operating room by suctioning it from a wound and running it through a machine that removes clots and washes the red blood cells before returning the fluid to the patient.
The technique also removes blood from patients undergoing surgery and sets it aside. The lost blood is then replaced with intravenous fluids. If patients bleed during the operation ?they are bleeding a thinned out product,? says Traviglino. ?It?s a good little trick we play on the body.? At the end of the operation the patient receives back the blood that was set aside.
Damon Keeley, the founder and CEO of Hemo Concepts, describes bloodless medicine as an approach that combines ?pharmaceuticals, medical devices and techniques in a systematic approach to patient care.?
Hemo Concepts provides advice on blood conservation methods during surgery to some 45 hospitals in New Jersey and New York. It hopes to expand well beyond this by building on the expertise of the Bloodless Medicine and Surgery Institute that it purchased last year [tk confirm check date with Keeley.} Hemo Concepts has some 40 employees and expects revenue of $4 million this year.
Keeley describes Sharon Vernon, the former nurse who founded the institute, as ?the leading educator in the world for bloodless medicine.? He says Vernon, now a Hemo Concepts vice president, has advised 55 of the roughly 100 hospitals in the U.S. and Europe that have adopted bloodless medicine programs.
Hemo Concepts last week rolled out a package of educational and consulting services at 22 Midwest hospitals run by VHA of Irving, Texas. CK Keeley says the package will cost the average size hospital about $32,000 and will deliver a fully operational program in six months.
He hopes to expand the program to many more of VHA?s 1,400 hospitals around the country as part of a four-year plan to increase the Hemo Concepts roster to 1,000 to 2,000 hospitals. That would still leave the closely held company with plenty of room to since the U.S. has more than 6,000 hospitals.
The costs of collecting and screening donor blood now amounts to about $500 a unit. WHAT?S A UNIT? According to Hemo Concepts, about 12 million units of red blood cells are transfused in the U.S. each year at a total cost of $6 billion. If the company?s recommended techniques were applied across the board, Keeley says, hospitals could cut the amount they spend on blood transfusions in half.
Vernon says mounting evidence shows that patients who avoid undergoing transfusions during or after surgery have shorter hospital stays and better overall outcomes than those who receive transfusions. One reason could be that transfused blood suppresses the recipients? immune system and makes them more vulnerable to infection.
?One of the newer revelations in medicine is that patients can survive with much lower hemoglobin than was thought 30 years ago,? Vernon. adds. She says it was once standard practice to give patients? transfusions if their hemoglobin level dropped below 10; that threshold has since been lowered to a level of seven.
Vernon, Keeley and Traviglino agree that situations such as accidents and severe traumas that cause rapid and heavy loss of blood will still require transfusions to be used. ?Our message is not that we won?t use blood,? says Vernon. ?It?s that we want to make sure our most precious resource is being used appropriately.?
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