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Saving a Life without a Blood Transfusion

Luka Still with his parents.

What do you do when doctors insist your son will die without a blood transfusion – which violates his religious beliefs and would sever you from your spiritual community?

Art and Liz Still, Jehovah's Witnesses from Liberty, Missouri, turned to The University of Kansas Health System and the region's most experienced nationally verified Level I Trauma Center. When patients reject blood transfusions for religious reasons, the trauma team respects their wishes, performing lifesaving procedures using the latest blood conservation techniques.

In 2010, Luka Still, then 22, suffered massive injuries in a high-speed motorcycle crash. He had severe traumatic brain injuries, countless broken bones and damage to internal organs. Doctors at another area hospital told Luka's parents he would not survive without a blood transfusion – a procedure their religion rejects.

A retired Kansas City Chiefs defensive end, Art thought he could take a crushing blow in stride. But nothing prepared him for the weighty decision before them. Refusing the blood transfusion, the Stills reached out to find alternatives.

Red blood cells.

Saving blood saves lives

In 2010, The University of Kansas Health System launched the state's first blood management initiative. Research indicates patient outcomes improve when blood products are used only when necessary.

Results over the first 4 years:

  • Reduced patient exposure to blood products by 58% (adjusted for hospital's increase in patient volume and in severity of conditions treated.
  • Reduced complications and lengths of stay.
  • Saved patients more than $12 million.

Blood management expert

"Elora Thorpe was the real catalyst in our decision to transfer Luka," Art says. "She's a national authority on blood conservation and has been very helpful to our religious community." A registered nurse, Thorpe is the hospital's transfusion safety nurse manager.

Two days after his accident, Luka arrived at The University of Kansas Health System clinging to life, dangerously anemic from blood loss.

"He was as close to brain dead as he could possibly be,” according to the health system's trauma and critical care director. "But it's not our job to try to convince patients or families to go against personal beliefs. We develop a strategy to support their wishes."

Initiative improves outcomes

The trauma team had adopted blood conservation strategies months earlier when the health system launched the state's first blood management initiative. Research indicates patient outcomes improve when blood products are used only when absolutely necessary.

Collaborating closely with neurosurgeon Jules Nazzaro, MD, orthopedic surgeons, blood management experts and other specialists, the team devised a coordinated approach to address Luka’s complex injuries. They delayed surgery for about 2 weeks to rebuild his blood supply and improve his condition.

For 5 weeks, Luka remained unconscious in intensive care. His family – he is one of 11 – showered love and support. After he awakened and left ICU, he spent another month on a recovery unit.

"Looking back, I honestly believe Luka would've died if we hadn't transferred him," Liz says.

Progress measured in years

With severe traumatic brain injuries, progress is measured in years. Six months after his accident, Luka remembered who he was and recognized his parents. Through continued physical and speech therapy, exercise, a careful diet and determination, he has become increasingly self-sufficient. Now 26, he lives with his family, but takes care of himself. Walking slowly with a cane, he makes witty conversation and structures his time in online research, reading and listening to music.

Doctor talking with patient

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