Winstein--14a

  Some of the medical uses of blood and major blood products
  Blood transfusion risks and alternatives
  Complications and risks
  Blood transfusion substitutes
  Blood transfusion safety
  Blood transfusions compared to eating blood

  Some of the medical uses of blood and major blood products

  http://en.wikipedia.org/wiki/Blood_transfusion
  http://en.wikipedia.org/wiki/Maternal_death
  http://www.netdoctor.co.uk/conditions/heart-and-blood/a1177/thrombocytopenia
-reduced-platelet-count/
  http://en.wikipedia.org/wiki/Thrombotic_thrombocytopenic_purpura
  http://en.wikipedia.org/wiki/Anemia
  http://en.wikipedia.org/wiki/Sickle-cell_disease
  http://en.wikipedia.org/wiki/Hemolytic_disease_of_the_newborn
  http://en.wikipedia.org/wiki/Evans_syndrome
  http://www.religioustolerance.org/witness5.htm

  Thanks to Nathan Natas for the report by Dr. Cassian Yee in the New England
Journal of Medicine.  A man's cancer was cured by the injection of cloned white
blood cells--"immunotherapy"-in 2008.  More trials will determine if it's a re-
liable treatment.
  http://www.telegraph.co.uk/news/science/science-news/3344810/Cancer-patient-
recovers-after-injection-of-immune-cells.html
  http://en.wikipedia.org/wiki/Immunotherapy#Genetically_Engineered_T_cells

  Blood transfusion risks and alternatives

  Since the JWs leaders propagandize against transfusion use by mischaracteriz-
ing the scriptures (that the scriptures require abstaining from transfusion of
blood and major blood fractions; see pp.1 and 12 to 42) and medical dangers
(making the facts fit the theory to rationalize their prophet playing; see the
entry for 2006 about "How Can Blood Save Your Life?" on p.1a), here is a section
of mainly Wikipedia articles on blood transfusion risks and alternatives.
  http://en.wikipedia.org/wiki/Blood_transfusion
  http://www.aabb.org/Pages/default.aspx
  http://www.noblood.org/

  Complications and risks

  Complications of transfusions
  https://en.wikipedia.org/wiki/Blood_transfusion#Adverse_effects

  There are risks associated with receiving a blood transfusion, and these must
be balanced against the benefit which is expected.  The most common adverse
reaction to a blood transfusion is a so-called febrile non-hemolytic transfusion
reaction, which consists of a fever which resolves on its own and causes no
lasting problems or side effects.

  Hemolytic reactions include chills, headache, backache, dyspnea, cyanosis,
chest pain, tachycardia and hypotension.

  Blood products can rarely be contaminated with bacteria; the risk of severe
bacterial infection and sepsis is estimated, as of 2002, at about 1 in 50,000
platelet transfusions, and 1 in 500,000 red blood cell transfusions.[10]

  Transmission of viral infection is a common concern with blood transfusion.
As of 2006, the risk of acquiring hepatitis B via blood transfusion in the Unit-
ed States is about 1 in 250,000 units transfused, and the risk of acquiring HIV
or hepatitis C in the U.S. via a blood transfusion is estimated at 1 per 2 mil-
lion units transfused.
  http://en.wikipedia.org/wiki/Hepatitis
  http://en.wikipedia.org/wiki/HIV

  "TRALI is the leading cause (around 50% of cases) of transfusion-related fa-
talities in the United States."  "The immune mediated form of TRALI occurs ap-
proximately once every 5000 transfusions and has a mortality of 6-9%."  "Treat-
ment for TRALI is primarily supportive measures.  Many patients with TRALI need
mechanical ventilation."
  https://en.wikipedia.org/wiki/Transfusion-related_acute_lung_injury

  Other risks associated with receiving a blood transfusion include volume over-
load, iron overload (with multiple red blood cell transfusions), transfusion-as-
sociated graft-vs.-host disease, anaphylactic reactions (in people with IgA def-
iciency), and acute hemolytic reactions (most commonly due to the administration
of mismatched blood types).

  Blood transfusion substitutes

  Main article: Blood substitutes
  http://en.wikipedia.org/wiki/Blood_substitute

  As of mid-2006, there are no clinically utilized oxygen-carrying blood substi-
tutes for humans; however, there are widely available non-blood volume expanders
and other blood-saving techniques.  These are helping doctors and surgeons avoid
the risks of disease transmission and immune suppression, address the chronic
blood donor shortage, and address the concerns of Jehovah's Witnesses and others
who have religious objections to receiving transfused blood.

  A number of blood substitutes are currently in the clinical evaluation stage.
Most attempts to find a suitable alternative to blood thus far have concentrated
on cell-free hemoglobin solutions.  Blood substitutes could make transfusions
more readily available in emergency medicine and in pre-hospital EMS care.  If
successful, such a blood substitute could save many lives, particularly in
trauma where massive blood loss results.

  Thanks to the post by HAL9000 at the Jehovahs Witness Discussion Forum web
site for the next report:
  http://www.jehovahs-witness.com/topic/143875/epo-bloodless-surgery?page=1&size=20

  Information on Erythropoiesis Stimulating Agents (ESA) (marketed as Procrit,
Epogen, and Aranesp)

  FDA ALERT [11/16/2006, Updated 2/16/2007 and 3/9/2007]: FDA is issuing this
alert to provide new safety information for erythropoiesis-stimulating agents
(ESAs) [Aranesp (darbepoetin alfa), Epogen (epoetin alfa), and Procrit (epoetin
alfa)].  Analyses of four new studies in patients with cancer found a higher
chance of serious and life-threatening side effects and/or death with the use of
ESAs.  These research studies were evaluating an unapproved dosing regimen, a
patient population for which ESAs are not approved, or a new unapproved ESA.
 
  In another study, patients scheduled for orthopedic surgery had a higher rate
of deep venous thrombosis when treated with Procrit at the approved dose.  This
new information is consistent with risks found in two clinical studies in pa-
tients with chronic renal failure treated with an unapproved regimen of an ESA
that were reported in November 2006 and are summarized in the data section be-
low.
 
  All ESAs have the same mechanism of action.  As a result, FDA believes these
new concerns apply to all ESAs and is re-evaluating how to safely use this pro-
duct class.  FDA and Amgen, the manufacturer of Aranesp, Epogen and Procrit,
have changed the full prescribing information for these drugs.  The new product
labeling includes a new boxed warning, updated warnings, and a change to the
dosage and administration sections for all ESAs.

  Blood transfusion safety

  As mentioned above, the major risks that the patient (donors and receivers)
may have encountered are the transmission of HIV or hepatitis and immunological
transfusion reactions.  Most of these problems are risky possibilities and can-
not always be effectively treated with appropriate medical care.  In many cases,
donors are either screened to reduce risks of these contaminations.

  - Hepatitis A, Hepatitis C or Hepatitis E can be transmitted in blood; the
donor may be obviously ill at the time of donation.
    http://en.wikipedia.org/wiki/Hepatitis_A
    http://en.wikipedia.org/wiki/Hepatitis_C
    http://en.wikipedia.org/wiki/Hepatitis_E

  - Malaria - Donors in the United States and Europe are screened for travel to
malarial risk countries, and in Australia donors are tested for malaria.
    http://en.wikipedia.org/wiki/Malaria

  - Chagas Disease - A screening test has been implemented for this disease in
the United States, but is not yet required.
    http://en.wikipedia.org/wiki/Chagas_disease

  - Babesiosis
    http://en.wikipedia.org/wiki/Babesiosis

  - Leishmaniasis
    http://en.wikipedia.org/wiki/Leishmaniasis

  - Simian foamy virus - While this virus can be transmitted by blood transfu-
sion, there is no evidence that it causes disease in humans.
    http://en.wikipedia.org/wiki/Simian_foamy_virus

  - Transfusion-related acute lung injury - A poorly understood syndrome which
is typically a response to products containing large amounts of plasma.  Pro-
ducts collected from female donors who have had multiple children are at high
risk for this complication.
    https://en.wikipedia.org/wiki/Transfusion-related_acute_lung_injury

  - Myocardial ischaemia - if the patient has a non-ST-segment elevation acute
coronary syndromes (NSTE-ACS).
    https://en.wikipedia.org/wiki/Coronary_artery_disease

  - Some medications may be transmitted in donated blood, and this is especially
a concern with pregnant women and medications such as Avodart and Propecia.

  - Creutzfeldt-Jakob Disease or CJD is extremely rare--about 1 in a million get
it.  The most common kind is vCJD (see below).
    http://en.wikipedia.org/wiki/Creutzfeldt%E2%80%93Jakob_disease
    http://en.wikipedia.org/wiki/Creutzfeldt%E2%80%93Jakob_disease#Epidemiology

  - vCJD, a disease in people (bovine spongiform encephalopathy or "mad cow
disease" is the disease in cattle), has been shown to be transmissible in blood
products.  Potential donors who have spent time in the United Kingdom or Europe
may not be allowed to donate due to this risk.
    http://en.wikipedia.org/wiki/Bovine_spongiform_encephalopathy#Epidemiology
    http://en.wikipedia.org/wiki/Creutzfeldt%E2%80%93Jakob_disease#Blood_donor_
restrictions

  - Bacterial contamination is a concern with any intravenous product, and is
especially problematic with blood products stored at room temperature (i.e.
platelets).

  - Graft-versus-host disease is possible when blood of a close relative is
transfused. Donations from relatives are often irradiated to prevent this.
    http://en.wikipedia.org/wiki/Graft-versus-host_disease

  - Cytomegalovirus or CMV is a major problem for patients with compromised im-
mune systems and for neonates, but is not generally a concern for most recipi-
ents.
    http://en.wikipedia.org/wiki/Cytomegalovirus

  - Epstein-Barr Virus or EBV is very common, but rarely causes clinical symp-
toms.
    https://en.wikipedia.org/wiki/Epstein%E2%80%93Barr_virus

  - Transfusion Associated Circulatory Overload (TACO) or excess iron are also
potential problems if a patient receives excessive transfusions.

  Reduction of nitric oxide may reduce the oxygen transmitting ability of stored
blood according to a 2007 study.
  http://www.washingtonpost.com/wp-dyn/content/article/2007/10/08/AR200710080
1433.html
  http://www.foxnews.com/story/2007/10/09/study-finds-stored-blood-lacks-nitric-
oxide-may-trigger-heart-attacks-strokes.html

  Studies have been inconsistent--some show older blood is less effective but
some show no difference.
  https://en.wikipedia.org/wiki/Blood_bank#Storage_and_management

  Hemanext may extend the shelf life of stored blood.
  http://www.innovation-america.org/extending-shelf-life-donated-blood


  Blood transfusions compared to eating blood

  Blood transfusions aren't processed by the body the same as eating blood.
Whole blood is transfused into the body intact, whereas when someone eats blood,
the body uses the amino acids and iron and only some parts of it enter the
bloodstream.

  (Thanks to Marvin Shilmer at the Jehovahs-Witness.net site for the next
quote.)

  "The question as to whether or not blood acts as food when transfused is of
interest. Hunter concludes that as it is not immediately destroyed, its nutri-
tive value is not as great as blood taken by mouth.  'We find that the loss of
weight in starvation is unaffected by the transfusion of blood in whatever quan-
tities and however often repeated, and this is the case even although at death
the blood may not only be increased in quantity but be actually richer in quali-
ty that in health.  This in one of Tchiriew’s experiments in which transfusion
had been repeatedly made and in which the weight had steadily fallen from 6.928
to 4.583 kilos, the quantity of blood obtained from the body amounted to about
8.7 per cent of the body weight as compared with the 7 per cent usually obtained
in health; and this blood contained 27.11 per cent of solids with 4.21 gms. of
nitrogen, as compared with the 21 per cent of solids containing about 3.2 gms.
of nitrogen usually found in healthy blood.  Similar results were obtained by
Panum, by a method, however, not as free from objection as that of Tchiriew, on
whose results, as one those of Foster, the greatest reliance can be placed.

  "The blood is primarily a carrier, and a given amount of transfused blood
would contain a certain amount of nourishment and a certain amount of waste ma-
terial.  When mingled with the blood of the recipient it would add the former to
the resources of the recipient to be taken up by then tissues while the waste
material would be excreted.  The blood corpuscles would perform their natural
functions unless there should happen to be hemolytic action, as there sometimes
is between similar bloods, and would suffer the same fate as the corpuscles of
the recipient.  The objection may be raised that transfused blood would not fol-
low this course, but as the weight of evidence is in favor of its acting just as
the animal’s own blood acts, the objection does not hold.  In short, as borne
out theoretically and by experiment, transfused blood is of very little, if of
any, value as a food for the recipient.  Large quantities of blood plasma would
be much more likely to nourish than equal quantities of whole blood, but it is
doubtful if enough could be injected to produce measurable results.” ("Hemorr-
hage and Transfusion; An Experimental and Clinical Research" by George W, Crile,
New York and London, D. Appleton and Company, 1909, Chap.XIII, "A General Re-
view of the More Modern Theories and Practice of Transfusion," pp.271-2)
  http://www.jehovahs-witness.com/topic/180976/watchtower-blood-transfusion-
denys-crile?page=1&size=20


  The JWs leaders' claim that a blood transfusion is encompassed by a Bible
verse about eating because a transfusion "nourishes" the body.  To support that,
they use a 17th century quote to that effect by a French physician named Denys
without being forthright that Denys is quoted by Crile, the author of the book
the quote is from (the same book quoted above), as an example of a broad use of
the word "nourishing" that was made without modern clarification of how blood
transfusions compare to "eating" blood.  ("The Watchtower," Sept.15, 1961, p.
558, "Respect for the Sanctity of Blood")
  http://www.jehovahs-witness.com/topic/180976/watchtower-blood-transfusion-
denys-crile?page=1&size=20

  That could be added to one of my chapters about the JWs leaders' misuse of re-
search material to make a source seem supportive that isn't--in this case,
Crile.  A broad sense of the word "nourishing" goes beyond what would have been
encompassed by a Bible verse, or anyone else's consideration, about "eating."
Sunlight, in a broad sense of the word "nourishing," could be considered as
nourishing the body in causing it to produce vitamin D, and a prosthetic limb or
heart valve could be considered as nourishing the body that way, but a Bible
verse about "eating" wouldn't have had those things as considerations nor typi-
cally would anyone else.  (Nobody speaks of someone "eating" sunlight or heart
valves.)  Therefore, if God, knowing how people understand words in order to
communicate to them, meant something about transfusions in Bible, He could have
made it clear and simple and wouldn't have expected anyone to assume it was cov-
ered by what anyone thought "eating" meant.

  Various types of Jews, Christians, and Muslims have the same verses to consid-
er, have believers as devout, yet only the JWs leaders, with "pour and bury"
verses given as covering things they don't, an analysis of the rules of Acts 15
without covering the mainstream understanding of those verses and Paul's verses
about food, etc., and in this case with a claim about what "eating" covers that
it doesn't, claim the Bible requires a ban of the medical use of blood and major
blood fractions.
  http://www.religioustolerance.org/witness5.htm
  http://www.chabad.org/library/article_cdo/aid/625443/jewish/Is-blood-transfu
sion-permissible-in-Jewish-belief.htm
  http://rchaimqoton.blogspot.com/2007/08/blood-transfusions-in-halacha-email.html
  http://www.islamqa.com/en/ref/2320
  http://www.angelfire.com/az/ambersukumaran/medicine.html
  http://www.donatelifenm.org/religiousviews.htm#buddhism