For Immediate Release
September 3, 2010

KOMSOMOLSK-ON-AMUR, Russia—One of the largest Internet service providers in eastern Russia, Technodesign, was compelled by court order to block access to several popular Web sites, including http://www.watchtower.org, the official Web site of Jehovah’s Witnesses.

The ruling was made by the Tsentralniy District Court of Komsomolsk-on-Amur on June 4, 2010, and came into force on June 16, 2010. The Watch Tower Bible and Tract Society of Pennsylvania (owner of the copyrighted materials on the Web site) and the Watchtower Bible and Tract Society of New York, Inc. (owner of the Internet site itself) were not called to participate in the case, nor did they receive a copy of the decision. Both corporations first learned of the decision on August 4, 2010, after Technodesign had already blocked access to the Internet site on July 30, 2010, in implementation of the court decision.

Once the decision was implemented, users in the area were unable to access watchtower.org. It appears that local officials want to prevent interested individuals from reading online any of the publications that the courts in Rostov and Gorno-Altaysk had pronounced extremist.

Contacts
In Belgium: European Association of Jehovah’s Christian Witnesses, telephone +32 2 782 0015
In Russia: Sergey Tarasov, telephone + 7 812 702 2691
In USA: J. R. Brown, telephone +1 718 560 5600

Source: JW Media

For Immediate Release
September 2, 2010

MOSCOW—On September 7, 2010, the Russian Federation Supreme Court will hear the interlocutory appeal filed by the Wachtturm Bibel- und Traktat-Gesellschaft der Zeugen Jehovas, against the September 11, 2009, decision of the Rostov Regional Court. The Rostov court’s decision wrongly labelled 34 Christian publications published by Wachtturm as extremist. At the time, the Rostov court did not even notify Wachtturm of the hearing and considered the case in the absence of its representatives.

Mr. Horst Henschel, a member of the board of directors of Wachtturm Bibel- und Traktat-Gesellschaft, expressed his bewilderment over this decision: “The hearing was held in our absence even though the court had the means to contact us, since each piece of our literature indicates the publisher’s data. The decision of September 11, 2009, grossly violated our rights since it negatively affected our reputation as a publisher and resulted in the Russian authorities refusing to allow us to import the literature, which we have been printing for Russia for several decades. We have disputed the decision in the Supreme Court and hope that Russia will act in a way proving that it desires to abide by international legal standards.”

Anton Omelchenko, an attorney and legal expert, commented on the incident: “The current trend of pronouncing religious literature as extremist in the absence of the publisher’s representatives is shocking. By preventing the publisher from defending its rights, the Rostov Regional Court made a serious mistake. Such a violation demonstrates discrimination, which is prohibited under the provisions of Article 14 of the European Convention.”

According to Mr. Henschel and the representatives of other foreign organizations, the upcoming hearing at the Supreme Court of Russia will have a crucial effect not only on the legal entities of Jehovah’s Witnesses but also on other foreign organizations that are present in Russia.

The court session of the Russia Supreme Court for the appeal will take place on September 7, 2010, at 10:30 a.m. at the following location: Moscow, ulitsa Povarskaya 15, hall 5038.

Contacts
In Russia: Sergey Tarasov, tel. +7 812 702 2691
In Germany: Wolfram Slupina, tel. + 49 6483 413110
In USA: J. R. Brown, tel. +1 718 560 5000

Source: JW Media

By Geraldine Fagan, Forum 18 News Service

Ilham Islamli has become the first reader of the works of the Muslim theologian Said Nursi – some of which are banned in Russia – to be convicted under the Criminal Code and punished under extremism-related charges, Forum 18 News Service notes. After two months’ pre-trial detention, Islamli was given a suspended sentence on 18 August by a court in Nizhny Novgorod for publishing Nursi’s works in Russian on a website he ran. A criminal case against another Nursi reader continues in Dagestan, though the case against a third has been dropped. For the first time, extremism-related criminal cases have now also been opened against three named individual Jehovah’s Witnesses. Launched after mass raids on his congregation, the case against Jehovah’s Witness elder Maksim Kalinin is said to have involved FSB security police surveillance using a secret video camera in his home, as well as their tapping of telephone calls made by seven other Jehovah’s Witnesses. In Altai Republic, extremism charges have already been brought against local Jehovah’s Witness leader Aleksandr Kalistratov, who faces possible imprisonment of up to three years if convicted.

A criminal extremism case against Maksim Kalinin, a Jehovah’s Witness elder in the Volga republic of Mari El, rests on FSB security police surveillance “using a hidden camera in his home without his knowledge”, Forum 18 News Service has learnt. “This means that at the current moment all 160,000 Jehovah’s Witnesses in Russia cannot feel secure even in their own homes,” Jehovah’s Witness spokesperson Grigory Martynov remarked to Forum 18 on 20 August.

Kalinin’s is one of the first three criminal cases to be opened against individual Jehovah’s Witnesses in connection with alleged extremist activity. If convicted under Criminal Code Article 282.2 (“organisation of activity by an extremist organisation”), he could face up to three years in prison.

The criminal cases against Jehovah’s Witnesses come as the first criminal trial in Russia of a reader of the works of the late Muslim theologian Said Nursi under extremism-related charges ended in a conviction and a suspended sentence, Forum 18 notes. Another criminal case continues.

The Mari El developments are part of an ongoing nationwide state campaign directed against Jehovah’s Witnesses. Begun in early 2009, the campaign intensified from 8 December 2009, when the Supreme Court upheld Rostov-on-Don Regional Court’s earlier ruling outlawing 34 Jehovah’s Witness titles as extremist and dissolving the local Jehovah’s Witness religious organisation in Taganrog (see F18News 8 December 2009 http://www.forum18.org/Archive.php?article_id=1385).

Similarly added to the Federal List of Extremist Materials, Russian translations of Nursi’s “Risale-i Nur” (“Messages of Light”) multi-part Koranic commentary were outlawed by Moscow’s Koptevo District Court in May 2007 (see F18News 27 June 2007 http://www.forum18.org/Archive.php?article_id=981). Nurdzhular – which Nursi readers insist does not exist – was then banned as an extremist organisation by Russia’s Supreme Court in April 2008 (see F18News 29 May 2008 http://www.forum18.org/Archive.php?article_id=1136).

Officials in various government agencies have refused to explain who initiated the campaigns against Jehovah’s Witnesses and readers of Said Nursi’s works (see F18News 25 March 2010 http://www.forum18.org/Archive.php?article_id=1426).

Martynov estimates that, in the wake of the Supreme Court ruling, law enforcement agents’ searches, brief detentions and similar incidents involving Jehovah’s Witnesses across Russia now total around 300.

Secret camera

Following 10 August raids on private homes and a Jehovah’s Witness worship service – at which he was present – Maksim Kalinin was formally declared a suspect in a case opened against him under Criminal Code Article 282.2 (“organisation of activity by an extremist organisation”) by Anton Vitsyuk, an investigator at Mari El Republic Public Prosecutor’s Office. While Kalinin was initially obliged to pledge not to leave the republican capital Yoshkar-Ola, this condition was lifted after ten days when no charges were brought against him, Martynov told Forum 18 on 23 August. Kalinin continues to be a suspect, however, and must remain available for questioning.

Despite the bans on literature and two local congregations in Moscow and Taganrog (Rostov-on-Don Region), the Russian Jehovah’s Witness organisation has not in fact been declared extremist, Forum 18 notes.

As a suspect rather than a witness, Kalinin exercised his right to demand materials related to his case. Among these, according to Martynov, a 30 March 2010 document issued by the Supreme Court of Mari El Republic contained information on FSB surveillance using a secret video camera in Kalinin’s home, as well as their tapping of telephone calls made by seven other Jehovah’s Witnesses. As the case continues, the Jehovah’s Witnesses are unable to publish the contents of this document.

Evening raids

On 10 August, soon after early evening worship attended by 90 Jehovah’s Witnesses – including Kalinin – began at a congregation member’s private house in Yoshkar-Ola, some 30 law enforcement agents – including FSB and Special Forces [Spetsnaz] – arrived. According to the Jehovah’s Witnesses, one mounted the pastors’ podium and interrupted the service. All present were then searched; some had personal items – including mobile phones – confiscated, others were issued summonses for questioning. No one was permitted to leave the building until 7am; when one woman felt ill, an ambulance was called but the law enforcement agents refused to allow paramedics to enter. At five believers’ homes in Yoshkar-Ola, literature was seized during similar raids lasting until 4am that night.

The Jehovah’s Witnesses attribute this action to a separate criminal case opened against unspecified members of the Yoshkar-Ola congregation. In a 6 August order seen by Forum 18, Anton Vitsyuk opens the case under Article 282, Part 1 of the Criminal Code (“hatred or enmity, as well as the humiliation of human dignity”) due to public activity by unnamed representatives of the local Jehovah’s Witness organisation in Yoshkar-Ola “aimed at belittling the dignity of a group of persons due to their attitude towards religion”.

Information confirming this “crime” was received from the republican FSB and counterextremism police departments on 2 August, the order notes. Specifically, it alleges that in 2010 the Jehovah’s Witnesses distributed banned extremist literature and preached publicly “on the exclusivity and superiority of adherents of the Jehovah’s Witness religious association over representatives of other Christian religions.”

Reached at the Public Prosecutor’s Office on 26 August, Vitsyuk confirmed that he had opened a criminal case against the Yoshkar-Ola Jehovah’s Witness community under Article 282, Part 1. However, he refused to comment further, directing Forum 18 to information about the case on the website of the Investigation Department of Mari El Republic Public Prosecutor’s Office. Asked to confirm whether information about Maksim Kalinin’s separate case was also on the website, Vitsyuk insisted he was not authorised to give information, and added that he was on holiday.

A 12 August news item on the Investigation Department website repeats details of the 6 August order. It also states that brochures confiscated from the Jehovah’s Witnesses will be “subject to careful analysis and expert investigation” and that “operative measures and investigatory action” are currently being taken “to ascertain all circumstances of the committed crime”. The website does not mention Kalinin’s case.

Earlier, religious extremism charges featured in the Mari El authorities’ prosecution of a local adherent of traditional Mari paganism (see F18News 29 May 2008 http://www.forum18.org/Archive.php?article_id=1136).

Gorno-Altaisk criminal charges

Also issued on 11 August, criminal charges under Article 282, Part 1 – seen by Forum 18 – have already been brought in a case against the leader of the local Jehovah’s Witness organisation in Gorno-Altaisk (Altai Republic), Aleksandr Kalistratov. While not in detention, Kalistratov has signed a pledge not to travel before his trial, which may begin in September or October 2010, Martynov believes. Article 282, Part 1 carries a maximum punishment of two years’ imprisonment.

Signed by Yevgeni Saidutov, an investigator with Altai Republic Public Prosecutor’s Office, the charges maintain that 34-year-old Kalistratov ordered religious literature – including 13 titles banned as extremist by Gorno-Altaisk City Court and 30 by Rostov-on-Don Regional Court – from the Jehovah’s Witnesses Russian headquarters in St Petersburg and organised its distribution by his community between October 2008 and the end of 2009. Specifically, it claims, Kalistratov visited A. Kandarakov at home in Gorno-Altaisk during the second half of December 2009 and gave him two copies of “What Does God Require of Us?” while knowing it had been banned by Gorno-Altaisk City Court on 1 October 2009.

Forum 18 notes that the Gorno-Altaisk ruling had not in fact entered force by the end of 2009 (see F18News 28 January 2010 http://www.forum18.org/Archive.php?article_id=1400).

Saidutov’s 18-page charges also list evidence of the literature’s allegedly extremist content. While largely consisting of criticism of Jehovah’s Witness Biblical commentary, they also maintain that an 8 April 1998 issue of “Awake!”, banned by Gorno-Altaisk City Court and now on the Federal List of Extremist Materials, is extremist due to the following passage: “We attended a church in Seattle (Washington State, USA), but this was purely a formality. Religion did not occupy an important place in our lives until Jamie, a cheerful young pioneer (a full-fledged preacher of the good news) knocked at our door. She was so nice that I agreed to study the Bible. Since Fred also showed an interest, Jamie’s parents led the study and a year later, in 1968, Fred and I were baptized. From the very beginning we had a sincere desire to place the interests of God’s Kingdom first in our lives.”

According to Saidutov’s charges, “this autobiography shows that Christianity in its widespread form and servants of the church could not attract the young couple, who professed Christianity only formally. The Jehovah’s Witnesses differ favourably from the Christian Church, because their doctrine aroused a sincere desire to follow it.” The passage is thus seen as “aimed at inciting hatred towards the Christian (Catholic) religion and Christian (Catholic) clergy as a social group”.

First criminal case against Jehovah’s Witness

Charges have yet to be brought in what appears to be the first extremism case opened against an individual Jehovah’s Witness in Russia, Martynov told Forum 18.

In a 21 July order seen by Forum 18, Nikolai Ivanov, an investigator with Tula Regional Public Prosecutor’s Office, opens a case under Article 282, Part 1 against Jehovah’s Witness Petr Babilyulka. On 30 June 2010, it alleges, Babilyulka distributed three copies of “What Does the Bible Really Teach?” – declared extremist by the Rostov-on-Don ruling – to an undetermined group of persons in a private flat in the city of Tula.

Babilyulka was imprisoned as a conscientious objector from 1956-62, according to the Jehovah’s Witnesses. “What is happening reminds me of the repression of Soviet times,” he remarked in their 10 August statement. “Unfortunately, 50 years on I am again having to give an explanation of my faith before the law enforcement organs.”

An 85-year-old Second World War veteran who later became a Jehovah’s Witness was fined 1,000 Roubles (99 Norwegian Kroner, 13 Euros, or 17 US Dollars) on 28 July for the administrative offence of “production and distribution of extremist materials” (Article 20.29 of the Administrative Violations Code) (see F18News 4 August 2010 http://www.forum18.org/Archive.php?article_id=1475).

Source: www.forum18.org

For Immediate Release
August 23, 2010

Familiar “bomb scare” tactic forces attendees to return home

STAVROPOL, Russia—“We’ve been waiting for this all year. Many of us took vacation and saved up money in order to come… and now there are garbage trucks blocking the entrance!”—Yuriy Savitskiy, 44.

On July 23, 2010, worshippers arriving to attend a three-day convention of Jehovah’s Witnesses in the Cossack village of Nezlobniy could not even enter the convention site. The head of the village police division, Yuriy Mukhin, had blocked the main entrance with his police car. As a result, peaceful religious services could not begin and the attendees, numbering nearly 2,000, were denied access to water, restrooms, or seating areas. Although similar religious meetings were previously held successfully in the same building, local authorities claimed that their actions were due to the prevalence of criminal activity in the southern regions from where many of the attendees had traveled.

Seeing that one of the Witnesses had a video camera, an officer with the Federal Security Service (FSB) who identified himself as Sergey Viktorovich, knocked it out of his hands and broke it. The Witness was also detained for questioning.

After being forced to stand at the gate for five hours, the Witnesses were allowed to enter the convention site. But Svetlana Zhurakovskaya, Deputy Head of the Village Administration, then took over the microphone on the platform and loudly declared an order to break up the religious meeting, at which point the electricity to the building was cut off.

Early the following morning, all entrances to the convention site were blocked by foul-smelling garbage trucks and the building was cordoned off by police officers. The Witnesses were again forced to wait on the street. Then a suspicious package with protruding wires was “discovered” in the same location where a car belonging to Police Chief for Public Safety Vladimir Lipov had been parked the previous day. The police ordered everyone to evacuate the area and the convention had to be canceled. The attendees were left with little choice but to return to their homes.

Similarly, during 2009 in towns across Russia that hosted conventions of Jehovah’s Witnesses, events were called off due to unannounced “fire inspections” during which the police would often “find” a “suspicious” package placed in the immediate vicinity of the convention location. The time needed to “neutralize” the package would drag on for hours and effectively result in the conventions being canceled and the attendees being sent home.

Contacts:
In Russia: Grigory Martynov, tel. +7 812 702 2691
In USA: J.R. Brown, tel. +1 718 560 5600

Source: JW Media

For Immediate Release
August 23, 2010

TULA, Russia—Pyotr Babilyulka, one of Jehovah’s Witnesses, was imprisoned from 1956 to 1962 for his refusal to take up arms. Now the 73-year-old great-grandfather finds it hard to believe that he is again facing court charges and possible imprisonment, this time under investigation for “extremism.”

On June 30, 2010, some new acquaintances of Mr. Babilyulka insisted they wanted three copies of the book What Does the Bible Really Teach? and claimed to be interested in a Bible study. Thereafter, Nikolay Ivanov, an investigator for the First Inter-District Investigation Department of the Tula Region Investigative Committee under the Russian Federation Prosecutor, initiated a case against Mr. Babilyulka under Article 282.1 of the Criminal Code of the Russian Federation (“Incitement to Hatred or Hostility or Denigration of Human Dignity on the Grounds of Religious Affiliation”). If Mr. Babilyulka is found guilty, he could face up to two years of imprisonment.

“This reminds me of the old Soviet repression,” said Mr. Babilyulka, “but it makes no sense at all. The activity of Jehovah’s Witnesses has never posed a threat to the government. We try to show love and kindness to people of all religions the way Jesus taught us. But sadly, 50 years later, I face the threat of being in prison again because of my faith.”

Mr. Babilyulka and his fellow worshippers believe that this incident is a result of the September 11, 2009, decision of the Rostov Regional Court to include the religious book What Does the Bible Really Teach? in a list of extremist materials. This book has been used for personal Bible study around the world, with over 130 million copies produced in 209 languages (including Russian and Russian Sign Language) since 2005. Jehovah’s Witnesses appealed the decision of the Rostov Regional Court to the European Court of Human Rights.

Contacts:
In Russia: Grigory Martynov, tel. +7 812 702 2691
In USA: J.R. Brown, tel. +1 718 560 5600

Source: JW Media

For Immediate Release
August 23, 2010

MOSCOW—“Russia has not seen a heat wave like this in recorded history. The resulting forest fires are taking a heavy toll on property and the populace alike,” related Grigory Martynov, of the Administrative Center of Jehovah’s Witnesses in Russia. As he tallied reports coming in from dozens of Witness congregations in the fire-stricken areas, he continued, “At the same time, as Jehovah’s Witnesses we view this situation as an opportunity to practice what the Bible teaches, by helping one another and helping our neighbors in need.”

One report states that 37 members of the small Vyksa Congregation of Jehovah’s Witnesses in the Nizhniy Novgorod Region (including adults and children) acted on the recommendation of congregation elders to evacuate during the night of July 29-30, 2010. They were then transported to neighboring towns where they were welcomed into the safety of fellow believers’ homes. One of the elders from the congregation, Yuriy Loboyko, lost his home when it burned to the ground. However, he remained joyful despite this loss because his family was safe and sound.

In the city of Voronezh, south of Moscow, a Witness family lost their home to the fire. Local government agencies provided funds for covering the family’s immediate needs and promised some compensation for rebuilding. Knowing that they are not the only ones suffering such losses, the family members are patiently awaiting receipt of the promised governmental assistance. In the meantime, Oleg Sklyadnev, a fellow Witness in the area, lovingly provided an apartment for the family to use until they can find a more permanent home.

The Administrative Center of Jehovah’s Witnesses in Russia quickly established relief committees to provide organized assistance in areas affected by the fires.

Contacts:
In Russia: Grigory Martynov, tel. +7 812 702 2691
In USA: J. R. Brown, tel. +1 718 560 5600

Source: JW Media

Dr. Clare Baker was head of cardiovascular surgery at St. Michael’s Hospital.

San Grewal

Dr. Clare Baker certainly lived up to the name of the town where he was raised: Biggar, Sask. From his early days in the once-bustling Prairie town, it was clear Baker was going to do big things.

By the time he retired in 1990, Baker had stablished himself as a pioneer in the field of cardiovascular surgery. He died Aug. 10 at the age of 87.

After high school, Baker turned down hockey and tennis scholarships from U.S. universities, his heart set on a career that would eventually lead him to a centre of medical innovation.

“His father was pretty annoyed when he turned down the scholarships,” said Baker’s wife, Emmaleen. “He was very good at hockey and tennis, but they weren’t medicine. He was determined to go into medicine.”

After graduating from the medical sciences program at the University of Saskatchewan in 1943, Baker received his MD from the University of Toronto in 1946. He went on to a surgical residency in The Hague, followed by training in thoracic surgery in Utrecht.

At a time when heart surgery was considered too complex and risky, Baker returned to Toronto, but studied under some of the leading surgeons in the burgeoning field at Johns Hopkins in Baltimore.

It was during his frequent flights to the U.S. in the early ’50s that he met his future wife, a nurse working as a “stewardess, at a time when you had to be a nurse to be able to keep passengers calm,” Emmaleen recalled. That wasn’t a problem for Baker.

He soon became head of cardiovascular surgery at St. Michael’s Hospital in Toronto and helped develop catheter procedures, performing 147 “bloodless” open heart surgeries without using transfusions on Jehovah’s Witness patients. He also performed five heart transplants.

For all his research and innovation, Baker received the Order of Canada. “But he was even more proud of his award from the University of Saskatchewan,” said his golfing buddy, Paul Murphy.

In 2008, Baker was named one of the university’s 100 most influential alumni.

“He’s right up there with John Diefenbaker,” said Emmaleen.

In addition to his wife, Baker leaves his sons John, Stephen and Edward.

Source: www.thestar.com

Chikondi Denemu, an 18-year-old Jehovah’s Witness, turned down one of three full scholarships arranged by private radio station Zodiak for students who excelled in their exams, station manager Gospel Kazako said.

Ms Denemu ‘declined a golden chance of her lifetime because her parents were concerned that Jehovah’s Witnesses are banned in China,’ Mr Kazako told AFP. ‘She told us after surfing the Internet she discovered that Jehovah’s Witnesses were banned in China and she consulted her church’s national headquarters who told her she can’t go.’

Mr Kazako said Zodiak had secured the scholarships ‘to empower the girl child in Malawi, the majority of them poor, vulnerable and victimised’.

Ms Denemu, who initially accepted the scholarship, was due to begin her five-year, all-expenses-paid studies next month at Shandong University, where she would have studied Chinese for a year before enrolling in medical school at Central South University in Hunan province.

Jehovah’s Witnesses, who number more than seven million worldwide, are evangelising Christians who consider modern churches to have deviated from the Bible’s true teachings, reject modern evolutionary theory and refuse blood transfusions. China does not formally recognise the faith, and Jehovah’s Witnesses say members have been arrested and detained for participating in prayer study.

Source: www.straitstimes.com

The kingdom hall is the centre for worship of Jehovah God. The hall was constructed over only two weekends last month by 400 unpaid volunteers. Most of the volunteers travelled from South Africa at their own expense and other areas in Botswana.

In southern Africa about 50 kingdom halls are built each year and this one will be the 55th hall to be dedicated by Jehovah Witnesses since last September. The construction work is overseen and administered by 25 regional building committees in South Africa and neighbouring countries and is a reflection of the worldwide work of the more than seven million Jehovah’s Witnesses in 236 lands. Due to the Bible study work of Witnesses there is an ongoing need for more kingdom halls.

A spokesperson of the organisation said the Gaborone Village congregation of Jehovah’s Witnesses would like to thank Tlokweng Land Board for granting permission to build the kingdom hall.

Source: www.mmegi.bw

A surgical team performs a minimally invasive mitral valve replacement at Swedish Medical Center in Seattle. Blood lost by the patient during surgery is held in the cell-saver reservoir below. Instead of being discarded, the blood will be cleaned and returned to the patient. This practice of conserving the patient's own blood and minimizing transfusions reduces infection and illness and improves recovery.

Cutting back on blood use could halt infections, illness — and even death

By JoNel Aleccia

SEATTLE — As a doctor and a patient, Dale Reisner knows the value of donated blood. But when the Seattle obstetrician had to have heart surgery four years ago, she did everything possible not to get a single drop.

“I don’t have any religious problems with it. If I was near death, I definitely would have taken blood, no question,” said Reisner, who is fine now at age 62. “But if I could avoid a transfusion by better pre-op preparation, then I was interested.”

Long dominated by Jehovah’s Witnesses — whose faith forbids blood transfusions — bloodless surgeries and blood conservation programs are now attracting mainstream patients worried about what some experts say are clear risks, including more infections, longer recuperation, increased illness and even death.

Dr. Dale Reisner actively avoided a blood transfusion during surgery to repair a mitral valve in her heart.

“The best blood is in your own veins,” said Dr. Lori Heller, medical director of the blood management program at Swedish Medical Center in Seattle, where Reisner had her surgery — without any transfusion. “We want to think before we transfuse.”

Decades of experience with Jehovah’s Witness patients, including 1.5 million members in the United States, has helped propel the new emphasis on blood management, said Sherri Ozawa, clinical director of the Institute for Patient Blood Management at Englewood Hospital and Medical Center in New Jersey.

“In the early days, it was, ‘We have Witness patients, what in the world do we do with them?’” she recalled. “Now we believe it should be the standard of care.”

Change in attitudes about blood
More doctors, from cardiac surgeons to orthopedists, are offering patients ways to conserve their own blood and avoid transfusions. From drugs that boost blood levels before surgery to cell salvage and blood diversion techniques during operations and lower thresholds for giving blood at all, the techniques are a sea change in the attitude that more blood is always better.

“There’s a movement across the country to use less blood,” said Dr. Marisa Marques, a professor of pathology at the University of Alabama at Birmingham Hospital, who has led a new program that has cut blood use there by at least 25 percent since 2003. At the same time, she said blood costs for the hospital fell by $3.5 million per year.

The number of U.S. hospitals with blood management programs has jumped from about 70 in 2002 to about 110 today. That’s still a fraction of the 5,815 registered hospitals in the country, but others are looking to adopt some of the techniques, said Dr. Darrell Triulzi, a professor of pathology at the University of Pittsburgh and vice president of the board of directors of AABB, an association of blood banks and professionals.

However, Triulzi and other critics caution that while thoughtful blood management is a good goal, the downside of transfusion isn’t as clear-cut as some advocates claim. Some studies have shown negative associations in patients who receive transfusions, but not that the blood caused the problems.

“You can’t tell whether it’s sicker patients that are getting transfused, or whether it’s from the transfusion itself,” he said.

In the U.S., which sucked up 14.4 million units of blood in 2007, blood use has been growing at about 2 percent to 3 percent a year. However, it’s expected to be flat when new figures come out this fall, Triulzi said. Part of that is fueled by the economic downturn, which put a damper on elective surgeries and left fewer patients with health insurance to pay for necessary operations. But part of it is fueled by a philosophical shift, particularly among some doctors.

“I shudder when I think about it,” said Heller, a cardiac anesthesiologist. “We used to just routinely transfuse.”

The shift started in about 1999, when first studies in Canada indicated that patients who got transfusions seemed to do worse than those who didn’t. Since then, the awareness has grown, said Dr. Timothy Hannon, a former Navy flight surgeon who founded Strategic Blood Management, an Indianapolis consulting firm hired by hospitals interested in cutting blood use.

“As our knowledge of transfusions has progressed, we find that transfusions are less beneficial than we once thought and more harmful,” Hannon said.

For some docs, transfusion is a habit
Still, many doctors today turn to transfusion as an automatic practice, giving borderline anemic patients smaller amounts of blood — often just one to two units — out of habit, said Hannon, who consulted worked with some 30 hospitals since 2001.

The trouble with that, said Marques, whose hospital hired Hannon, is that every blood transfusion is like a miniature organ transplant, with the potential for reactions, errors and infections.

“Anytime we’re exposed to someone else’s blood, we’re exposed to antibodies we’ve never seen before,” she said. “People think blood is lifesaving, but complications are the price you pay.”

Studies have shown that blood transfusions are associated with higher levels of hospital-related infections, pneumonia and central-line sepsis, a blood infection.

They’re also linked to longer stays in the hospital and the ICU, research indicates. In 2007, there were 72,000 transfusion-related adverse events in the U.S., according to the AABB’s most recent figures. Of those, 11,000 were severe problems and 40 people died.

For consumers haunted by the HIV outbreaks of the 1980s, transmitted infections were a reason to fear blood. Today, however, the estimated risk of a major viral infection from a unit of blood is very low — about 1 in 1 million units of blood, according to a 2008 study in the journal Advanced Studies in Medicine.

By contrast, the risk of complications not related to infection — such the potentially fatal condition known as TRALI, or transfusion-related acute lung injury — is estimated to be about 1 in every 5,000 units of blood component transfused, and possibly more.

In addition, recent studies have shown that storing blood too long reduces its ability to carry oxygen in the body and increases chances of complications.

Use blood, but with care
Sometimes, however, blood transfusions are the only solution to save lives, notes the American Red Cross, which generally supports conservation efforts. In cases of severe trauma or anemia, transfusions are appropriate, agreed Hannon, a practicing anesthesiologist who orders blood himself.

Blood leaves the cell saver reservoir and enters the yellow machine at bottom, where it's spun through centrifuges to separate wastes from red blood cells.

The trick, he said, is to be judicious. Make sure patients aren’t anemic before they show up for surgery. Build up their blood with iron or erythropoietin, or EPO, a hormone that promotes the formation of red blood cells. Reduce the amounts of blood draws or eliminate some tests entirely.

“If you are in the ICU for five or so days, you’re going to get an extra unit of blood because the vampires have taken so much,” Hannon said. “We have a lot of wastage.”

At the crux of the controversy over blood use centers is disagreement over the so-called “hemoglobin trigger,” the level at which a patient must be transfused.

Normal hemoglobin levels are about 15 grams per deciliter for young adults. Doctors in many fields have traditionally called for transfusions when patients’ levels fall much below 10 grams/dl and definitely when they get around 8 grams/dl.

But advocates like Hannon say it can be perfectly safe to hold off on transfusions in otherwise healthy people until their levels fall much lower. That, said Triulzi, is where some doctors draw the line.

“The question is, can we let them go down to the 7 to 7.5 range, or do they need to be transfused at the 9 range?” he said.

The cleaned and concentrated red blood cells are collected here before returning to the patient.

Right now, guidlines for blood transfusions are variable and subject to interpretation, so most doctors rely on past practice and their assessment of how sick a patient might be.

Triulzi said many doctors are waiting for long-term data — and clear guidelines. But Hannon said doctors and patients shouldn’t simply wait for research conclusions to consider changes in blood practice. They should educate themselves — and their patients — now about ways to use less blood.

“This is not zealous, this is not crazy, this is not fringe medicine,” he said, adding later: “Good hospitals want to get even better. They want to do the right thing. They just need to know what that is.”

Source: www.msnbc.msn.com