Liv Osby

losby@gannett.com

When Jim Steenhuizen wound up in the intensive care unit with massive internal bleeding, doctors ordered a blood transfusion to save him.

But even though his condition was serious, the father of two refused.

As a Jehovah’s Witness, his religion forbids taking blood transfusions from another person.

So doctors tried a new blood replacement product, which was acceptable.

And after a few weeks, the 48-year-old Anderson man was back at work delivering the mail on his rural route thanks to Sanguinate.

“I had never heard of it. And I was very thankful for it,” he told The Greenville News. “I try not to think about what might have happened.”

Dr. Sharif Khan, a hematologist with Bon Secours St. Francis Health System where Steenhuizen was treated, said it’s challenging when providers can’t offer supportive care because of religious restrictions. But Sanguinate could solve that problem.

“About 85 percent to 90 percent of Jehovah’s Witness patients who are told about this product accept it,” he said. “He got several doses and was stabilized. And he made a complete recovery.”

Promising alternative

As a result of vehicle crashes, injuries and illness, about 13.2 million transfusions are performed every year in the U.S., according to the National Institutes of Health.

And there are 1.04 million Jehovah’s Witnesses, according to nationmaster.com, which compiles data about a variety of issues.

There are others who can’t take blood transfusions as well, including those who develop multiple antibodies for whom matching blood can’t be found, such as patients with sickle cell disease, Khan said.

An alternative could be helpful in those circumstances, he said. But earlier efforts to develop such a product have proven unsuccessful, he said, and even dangerous.

As a physician specializing in disorders of the blood, Khan followed the research and learned about Sanguinate. It looked more promising than the previous attempts.

Sanguinate is produced through a process that links molecules from cow’s blood with molecules from carbon monoxide to create a bigger molecule that lasts longer than human blood and doesn’t have to be refrigerated, he said. It’s manufactured by New Jersey-based Prolong Pharmaceuticals.

As a stabilizing agent, Sanguinate is not being considered as a replacement for chronic blood transfusions, he said. Rather, it’s used as a bridge to something else — surgery to stop the bleeding or buying enough time until the body can make more of its own blood, he said.

Danger zone

When Steenhuizen arrived at the hospital, he was bleeding severely in his intestines, Khan said. He’d lost more than 80 percent of his red cells — the cells that carry oxygen to the brain, kidneys and other vital organs.

A search located some Sanguinate at a hospital in Charlotte, he said. And a staffer drove there to retrieve it.

At the time, Steenhuizen was facing multiple organ failure, Khan said. But after receiving a few units of Sanguinate, his oxygen level improved substantially and he was out of the danger zone.

“He was completely coherent, his oxygen level was up,” he said. “And made a complete recovery.”

After that, St. Francis became one of 27 sites involved in a Phase 2 clinical trial of Sanguinate already underway across the country when blood is not an option, whether for religious or medical reasons, he said.

It’s hoped that it can one day be used by the military in battlefield conditions and by EMTs who arrive on the scene to find a victim bleeding profusely, Khan said.

“If somebody has been in a crash, the (EMTs) can’t stick an IV into their arm and start blood,” he said. “And the Department of Defense is interested in research into these products for obvious reasons. They are stored like medications on shelves, not refrigerated, and they can be carried in an ambulance or military vehicle.”

They don’t need to typed either like blood does, he said. And while undetected diseases may be spread through human blood transfusions, the manufacturing process destroys all the organisms in the cow’s blood that might cause disease, he said.

But Sanguinate is not without risks, though they’re considered manageable, he said. Patients must be monitored closely for potentially dangerous blood pressure spikes and kidney dysfunction.

Staying alive

Steenhuizen developed internal bleeding on Feb. 13 — as best anyone can figure from taking ibuprofen for his back pain. Ibuprofen is one of a number of non-steroidal anti-inflammatory drugs, or NSAIDs, that can cause bleeding in some people. A day later, he was in the ICU.

At that point, he said, his hemoglobin was a fraction of what it should have been. But a life-saving transfusion was out of the question because of the religion he and his family observe.

“Because of my stance as a Jehovah’s Witness, I refused to take blood,” he said. “The Bible states to abstain from blood, that blood is sacred and belongs to God.

“If I was to die because I didn’t take blood, I would have died in good standing with Jehovah, my God,” he added. “And my family was OK with that.”

Thankfully, it never came to that. As his concerned doctors were considering surgery to try and stop the bleeding, they decided to try Sanguinate along with other medications he was given. And slowly, his blood count began to rise.

“The main thing was to boost the oxygen level to the organs to keep me alive,” he said. “Eventually ... my blood cells started going up.”

Steenhuizen was released after two weeks in the hospital and was back at work on March 11. He no longer takes NSAIDS, says he’s pretty much back to normal, and is glad that Sanguinate is available for him and other Jehovah’s Witnesses.

“I think it was a great product. And I think it could benefit others,” he said. “It saved my life.”