Knowing that it would conflict with his religious beliefs, Walker Swofford put off having open heart surgery for as long as possible – until his symptoms got so bad that he would get winded just walking to his car.

“I was in denial at first,” the Inglewood resident said. “I didn’t want to accept it.”

His physician said he couldn’t repair his calcified arteries without giving Swofford donor blood during the procedure, a practice that is prohibited by the Jehovah’s Witness faith.

After asking around, Swofford, 60, learned about Dr. Manuel Estioko, a surgeon who came to Torrance Memorial Medical Center a year ago. Estioko is credited with pioneering the practice of “transfusion-free” heart surgery.

Under the guidance of Estioko, the hospital is now looking at a range of ways it can minimize blood use, which has been shown to have both financial and medical benefits for a range of surgical procedures, officials say.

“In the past we used blood fairly liberally,” said Dr. John McNamara, chief medical officer at Torrance Memorial. “If they can match it correctly, we never really thought too much about it. what caught our attention is the knowledge that patients don’t do as well (with donor blood).”

Estioko and a small group of physicians – at the urging and encouragement of Jehovah’s Witness officials – first began looking into so-called “bloodless” medicine more than 40 years ago.

At the time, health officials were also alarmed by the high incidence of hepatitis transmission from blood donors. In the 1970s, a staggering 18 percent of patients who underwent blood transfusion could expect to contract the blood-borne illness.

Though better screening has led to steep declines in the spread of hepatitis, bloodless surgery is now making its way into mainstream medicine because of its positive health outcomes and shortages in the nation’s blood supply. the Joint Commission, the accrediting agency for most hospitals, is expected to announce new guidelines for blood management this year.

Estioko first began performing transfusion-free surgery in 1996. the only other hospitals in Los Angeles County with bloodless programs are St. John’s Health Center in Santa Monica and Good Samaritan Hospital in Los Angeles, both facilities where Estioko has worked.

“All of the evidence supports the conclusion that patients who do not receive blood have better outcomes,” Estioko said. “Both short and long term, patients do better.”

The procedure does require more planning. Patients must be screened for anemia and other blood disorders, and must be watched closely after the surgery for signs of bleeding or hypertension. during the procedure, blood loss is minimized by use of a range of techniques, including a special scalpel that burns rather than cuts tissue.

New technology also allows the patient’s own blood to be collected, cleaned and recycled back into the body. In some cases, patients can donate their own blood in advance of surgery for use during the procedure.

So far, Estioko is the only surgeon performing transfusion-free heart surgery at Torrance Memorial, but McNamara said blood management techniques are being implemented across all surgical fields.

One of the benefits is that it saves money. the annual cost of blood for a hospital the size of Torrance Memorial can reach $2 million, McNamara said – and double or triple that amount to store and administer the blood.

In its analysis of hospital practices, the Joint Commission found that most hospitals are using or requesting more blood than they need, which further strains the nation’s blood supply. the commission recently finished a pilot program with 75 hospitals across the country that agreed to employ better blood management practices.

New regulations requiring hospitals to improve their management of blood are likely to be issued soon, officials said.

Developments in this field are welcomed by the Jehovah’s Witness community, which formally banned the practice of receiving blood transfusions – even when the patient’s life could be at stake – in the 1940s.

“Blood represents the life of the creature,” said JR Brown, spokesman for the Brooklyn, N.Y.-based church. “We feel it is sacred, something that cannot be duplicated by men.”

The belief is rooted in biblical scripture, though most Christians interpret the passages differently and allow blood transfusions.

The Jehovah’s Witness denomination, which claims 1.2 million members in the United States, keeps a list of hospitals and physicians who practice bloodless medicine. Stafford said he learned about Estioko from a member of his congregation.

“He assured me that he could do this procedure,” said Swofford, who had to change his insurance carrier to have the procedure last summer. “I was very relieved.”

His recovery lasted about a week, and he said he feels much better.

“I’m exercising regularly, walking every day,” he said. “The procedure couldn’t have gone any better.”