Nationwide Children's Hospital in Ohio, USA, performed its first successful bloodless heart transplant on a 6-year-old boy, Andrew Craver, in December 2010. Mark Galantowicz, MD, FACS, chief of Cardiothoracic Surgery at Nationwide Children's, said that it took an entire team dedicated to blood conservation before, during and after the surgery to make it successful. It also takes a team with the experience of a systematic approach of always trying to achieve a bloodless outcome no matter the case. “We not only conserve blood when a patient's family makes the request, but we do so during all procedures and surgeries here at The Heart Center,” said Dr. Galantowicz. When the body is introduced to something foreign (e.g. a blood transfusion), it stimulates the immune system resulting in an inflammatory response. With that inflammatory response, the body swells and there is risk of infection. The bloodless transplant was also a religious preference for Andrew's father and mother, Ian and Rachel Craver, with the philosophy to avoid blood transfusions.

 Some of the techniques employed by Dr. Galantowicz and his team include limiting how much blood they take for testing preoperatively; using a machine -known as a 'cell saver' during the procedure which captures shed blood, processes it and puts it right back into the body; and utilizing modified tubes and heart/lung bypass machines which have smaller components to reduce the necessity for blood. Andrew's case – a heart transplant – presented the ultimate challenge for the team in blood conservation. And seven months later, Timothy Hoffman, MD, medical director of the Heart Transplant and Heart Failure Programme at Nationwide Children's, was happy with Andrew's outcome. Andrew had been under his care from the time he was a 3-year-old. Andrew had dilated cardiomyopathy in which the heart is weakened and enlarged. Eventually, his heart failure worsened despite maximal outpatient therapy. It was then, at the end of 2010, that Andrew was placed on the heart transplant waiting list. And, today, Andrew is back to being an active 6-year-old full of energy.