What is a transfusion-free (bloodless) stem cell transplant?
Bone marrow transplants, also known as stem cell transplants, typically involve blood transfusions that include healthy red blood cells and platelets. Products for these transfusions often come from blood donors.
Some people can’t or won’t accept donor-based blood products due to religious, personal, or medical reasons. They can still receive safe, high-quality care using methods that promote a patient’s own healthy blood production in other ways. The Penn Medicine Center for Transfusion-Free Medicine offers options for people who decline blood transfusions. We performed the world’s first bloodless stem cell transplant and continue to lead advances in bloodless methods and care.
Who might receive a bone marrow transplant without blood products?
Bone marrow transplants are typically used to treat leukemia, lymphoma, or multiple myeloma. Generally, anyone cleared for this type of transplant is eligible for a bloodless process.
People whose religious beliefs prohibit accepting donated blood, such as Jehovah’s Witnesses, often request bloodless procedures. Others choose this method to avoid the small risks associated with receiving live blood cells from another person, like allergic reactions and immune problems that can lead to infections. Talk with your care team to discuss whether a bloodless bone marrow transplant is right for you.
What to expect from your transfusion-free stem cell procedure
Penn Medicine developed a special process for reliable, effective bone marrow transplants without using blood products. While bloodless procedures are largely similar to processes that use blood transfusions, there are some differences. From the first meeting, a specially trained nurse practitioner will explain how the bloodless procedures work and describe the unique features you can expect.
Transfusions from blood donors are used to maintain adequate blood cell and platelet counts and meet other medical requirements for transplantation. In bloodless procedures, doctors address these needs in several ways:
- Our team makes sure you have the right amount of red blood cells and hemoglobin, a protein inside red blood cells. Iron is delivered through an IV (intravenous line) with medications that stimulate red blood cell development to help prevent anemia.
- Platelets are cells in the blood that assist with clotting. With bloodless procedures, we administer vitamin K and clotting medications to make sure you have sufficient platelet counts to avoid bleeding incidents.
- Stem cells used for transplants are often stored in plasma, which is a blood product. Penn Medicine and the American Red Cross collaborated to develop plasma-free storage that we use in our bloodless methods.
- For those with heart conditions, we work closely with your cardiologist or one of Penn Medicine’s cardiologists to adjust heart medications as needed as part of the bloodless protocol.
We respect the reasons why people choose bloodless medicine for their stem cell transplantation process. Our care teams can answer questions, guide you through the process, and ensure that you proceed with confidence.
All our coordinators offer compassionate care during each step of your treatment journey. For example, because many Jehovah’s Witnesses seek our bloodless medicine care, we employ Jehovah’s Witnesses as coordinators in our program to address specific concerns they may have.
We also understand that people who seek bloodless treatments must sometimes travel great distances to find services outside of their insurance network. We work with insurance companies early to address possible issues and help you obtain needed coverage.
Recovery after a transfusion-free stem cell transplant
The advantages of bloodless transfer procedures can include a quicker recovery, a shorter hospital stay, less blood loss, and a lower likelihood of blood contamination. You’ll be monitored closely before, during, and after your bone marrow transplant to ensure that all aspects of your bloodless procedure follow the highest medical standards to support a healthy recovery.
Pioneers in bloodless medicine treatments
Penn Medicine is one of very few bloodless medicine programs in the United States. After making history with the world’s first successful bloodless stem cell transplant, our program continues to lead the field, offering:
- Extensive experience: We pioneered bloodless medicine approaches, and our program is internationally recognized for excellence. We even teach other providers how to incorporate bloodless medicine into their protocols.
- A record of success and safety: We’ve performed hundreds of effective transfusion-free stem cell transplants and procedures with no major bleeding episodes.
- Treatment for people turned away elsewhere: Many centers refuse to treat those who won’t accept blood transfusions. We welcome these patients and work with them to meet their personal needs and preferences.
- Assistance with financial matters: We work with insurance companies to get bloodless medicine treatments covered. We can also assist with parking, lodging, and food for people in need, especially those traveling long distances for treatment.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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