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Bloodless medicine and surgery

What bloodless medicine
and surgery is

Bloodless, or transfusion-free, care means planning treatment so it can be done without donated blood. Here's how hospital programs describe it and which techniques they use.

Cited sources Sources checked Nov 7, 2026 Not yet clinician-reviewed

A definition

Hospital programs describe bloodless medicine and surgery as medical and surgical care without blood transfusions. Englewood Health says its program aims to respect the needs of patients for whom blood transfusion is not an option.[1] The University of Rochester describes transfusion-free medical and surgical techniques that respect the needs of patients who choose to refuse transfusion.[2]

It sits inside a wider approach called patient blood management, which the World Health Organization describes as addressing iron deficiency, anaemia, clotting problems and blood loss.[3]

Who it's for

Programs serve people who can't or prefer not to receive blood. Hartford Hospital says its techniques are for all patients with religious and personal beliefs regarding blood transfusions.[4] UPMC describes support for patients who want to limit transfusions as well as for people who can't receive them.[5]

A 2021 review notes that more than 8.5 million people observe the Jehovah's Witness faith and generally refuse transfusion of blood and blood products, and describes a collaborative approach to their care around surgery.[6] Individual beliefs vary, so programs typically discuss each person's choices one by one.

The three parts of the approach

1. Prepare your bloodFind and treat anemia and iron deficiency before treatment.
2. Save bloodReduce blood loss during treatment, including fewer blood tests.
3. Tolerate anemia safelyRely on the body's tolerance of anemia and careful transfusion thresholds.

This "three-pillar" structure is how researchers describe multimodal patient blood management programs: managing anemia, minimizing unnecessary blood loss, and harnessing the body's tolerance of anemia.[7] The review on Jehovah's Witness patients describes the same steps: optimizing hemoglobin before surgery, salvaging blood during it, and minimizing blood draws afterwards.[6]

Techniques programs mention

  • Treating anemia before surgery, for example with iron.[8] See anemia and iron before surgery.
  • Minimally invasive surgery and blood salvage, both named by Englewood Health among its transfusion-free techniques.[1] See cell salvage explained.
  • Medicines that reduce bleeding, such as tranexamic acid.[9]
  • Fewer blood draws after surgery.[6]

The evidence for each is summarized on alternatives to blood transfusion.

Bloodless care isn't a single procedure. It's a plan built around one patient, usually starting weeks before surgery, and it works best when the whole team knows your wishes in advance.

Looking for a program near you?

How to search directories and what to ask when you call.

Find a program
Questions

Common questions

Can any hospital do bloodless surgery?

Many of the techniques are used widely as part of patient blood management.[3] Dedicated programs add coordination, such as staff who help plan care for patients who decline transfusion.[5, 1] Ask your hospital what it offers.

Do I have to be religious to use a bloodless program?

No. Programs describe serving patients with religious and personal reasons.[4, 5]

Talk to your care team. This page summarizes published research and patient information for general education. It is not medical advice and has not yet been reviewed by a clinician. Your surgeon, anesthesiologist or doctor can tell you what applies to you.
Sources

References

All sources read on Nov 7, 2026. Links go to the publisher, PubMed abstract or official page.

  1. Englewood Health. Bloodless Medicine and Surgery (program page). www.englewoodhealth.org/service/bloodless-medicine-and-surgery
  2. University of Rochester Medical Center. Bloodless Medicine and Surgery (program page). www.urmc.rochester.edu/pathology-labs/clinical/blood-bank-transfusion-medicine/patient-blood-management/bloodless-medicine-and-surgery
  3. World Health Organization. The urgent need to implement patient blood management: policy brief. 2021. www.who.int/publications/i/item/9789240035744
  4. Hartford Hospital. Bloodless Center (program page). hartfordhospital.org/locations/medical-office-building/bloodless-center
  5. UPMC. Patient Blood Management Program (program page). www.upmc.com/services/patient-blood-management-bloodless-medicine
  6. Rashid M, Kromah F, Cooper C. Blood transfusion and alternatives in Jehovah's Witness patients. Curr Opin Anaesthesiol. 2021;34(2):125-130. PMID 33577206. pubmed.ncbi.nlm.nih.gov/33577206
  7. Althoff FC, et al. Multimodal Patient Blood Management Program Based on a Three-pillar Strategy: A Systematic Review and Meta-analysis. Ann Surg. 2019;269(5):794-804. PMID 30418206. pubmed.ncbi.nlm.nih.gov/30418206
  8. Muñoz M, Acheson AG, et al. International consensus statement on the peri-operative management of anaemia and iron deficiency. Anaesthesia. 2017;72(2):233-247. PMID 27996086. pubmed.ncbi.nlm.nih.gov/27996086
  9. Henry DA, et al. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev. 2011;(3):CD001886. PMID 21412876. pubmed.ncbi.nlm.nih.gov/21412876