Blood Transfusion Alternatives: A Guide to Blood-Free Surgical Options

Exploring Safe and Ethical Alternatives to Blood Transfusions

Are you considering a medical procedure but concerned about receiving a blood transfusion? You are not alone, and you are not without options. Whether due to personal beliefs, medical conditions, or safety concerns, many people today are seeking alternatives to traditional blood transfusions. The good news is that modern medicine offers a growing number of effective and evidence-based solutions that do not rely on donated blood.

In this article, we will explore a variety of safe, ethical, and innovative alternatives to blood transfusion, including advanced surgical techniques, natural blood-building therapies, and cutting-edge technologies. Whether preparing for surgery or simply wanting to stay informed, this guide will give you the confidence and knowledge to make empowered health choices.

Blood-Free Medicine: Safe, Ethical Alternatives to Transfusions

More people than ever are choosing to say no to blood transfusions — and they’re doing so safely, ethically, and confidently. Whether it’s because of personal beliefs, medical concerns, or past experiences, the demand for blood-free healthcare is growing across the UK.

The good news? Thanks to medical advances, patients have more options than ever before.

See our short video (below) that explains alternatives to blood transfusions…

Why Some People Refuse Blood Transfusions

1. Religious and ethical beliefs

• Some faiths, such as Jehovah’s Witnesses, refuse blood on scriptural grounds.

• Others prioritise bodily autonomy, natural healing, or non-invasive care.

2. Safety concerns

• The Infected Blood Scandal of the 1970s–1990s led to over 30,000 people in the UK being infected with HIV or hepatitis C through contaminated blood.

• Blood was sourced from high-risk donors, including prisoners and drug users in the US.

• The UK government delayed the use of safer, heat-treated products and failed to inform many patients.

3. Loss of trust in the system

• Patients affected by the scandal — or those who lived through it — still struggle with confidence in blood-based treatments today.

• Some patients are simply unwilling to accept any level of risk or uncertainty.

“After learning what happened in the contaminated blood scandal, I just couldn’t accept the risk — even if it’s considered small.”
— Patient, Leeds

Clinically Approved Alternatives to Blood Transfusions

Thanks to modern healthcare, refusing blood does not mean refusing treatment. Below are some of the most commonly used alternatives, many of which are already standard in NHS and private hospitals.

Volume Expanders (Non-Blood Fluids)

These help stabilise blood pressure and circulation during trauma, surgery, or blood loss. They don’t carry oxygen, but they support the body while other therapies take effect.

• Gelofusine – synthetic, long-lasting, and fast-acting plasma substitute

• Ringer’s Lactate (Hartmann’s Solution) – mimics natural plasma and balances electrolytes

• Normal Saline – widely used, safe, and universally accepted

✅ Accepted by most patients avoiding blood
✅ Widely available in NHS hospitals

Minor Blood Fractions (Grey Area)

These are purified components derived from plasma, not whole blood. Acceptance varies by individual or religious belief.

• Albumin – stabilises blood volume in trauma, burns, and liver failure

• May be accepted by some patients who reject transfusions, depending on interpretation

“I decided to avoid all blood-based products, including albumin. The team respected that and found an alternative.”
— Patient, Cardiff

Iron Therapy and Erythropoietin (EPO)

These boost the body’s natural red blood cell production, especially useful before surgery or in cases of chronic anaemia.

• Iron infusions build haemoglobin levels

• EPO injections stimulate red blood cell formation

✅ Accepted by patients avoiding blood
✅ Requires planning but effective and widely available

Artificial Oxygen Carriers

These experimental treatments aim to carry oxygen without using human blood.

• Hemopure® (HBOC) – made from bovine haemoglobin; not yet licensed for general use in the UK

• Perfluorocarbons (PFCs) – synthetic chemicals that dissolve oxygen in plasma

⚠️ Available under special access or trial protocols only
✅ Can be considered in an emergency with documented consent

Haemostatic Agents

These control bleeding during trauma or surgery.

• Tranexamic Acid (TXA) – reduces excessive bleeding

• Fibrin sealants / surgical glues – Seal wounds directly, avoiding systemic interventions

✅ Accepted and used across NHS settings
✅ Especially useful in obstetrics and major surgeries

Cell Salvage Technology

Cell salvage machines collect, clean, and return a patient’s own blood during surgery.

• Used in cardiac, spinal, orthopaedic, and trauma procedures

• Available in many UK hospitals, including:

  • St. Thomas’ Hospital, London

  • Royal Cornwall Hospital

  • University Hospitals Birmingham NHS Foundation Trust

Key Alternatives at a Glance

Preparing for Unexpected Medical Events

You can’t avoid accidents or illness, but you CAN plan for how a serious accident or illness will affect you – especially if you become unconscious or unable to communicate.

The Importance of a Medical Protection System

Without a medical protection system in place, medical staff will normally administer treatments and procedures they believe are best for you.

Ensuring Your Medical Decisions Are Respected

My Medical Choice equips our members with a specialised document that ensures their medical wishes are legally binding and remain unchallenged.

In fact, you can also reject blood transfusions in emergencies, and that choice is also legally binding.

The Power of Informed Medical Decisions

As with anything in life, knowledge is power. If you don’t know about alternatives to blood, how can you reject a transfusion or blood products?

Many people remain unaware that the NHS offers a variety of safe and proven alternatives to blood transfusions. My Medical Choice has produced a video to guide you through these options, applicable in both emergency and scheduled surgical contexts.

My Medical Choice – protecting your healthcare choices.