ABO blood group system and likely predates human migration from Africa. The O01 allele is considered to predate the O02 allele. Some evolutionary biologists theorize that there are four main lineages of the ABO gene and that mutations creating type O have occurred at least three times in humans. From oldest to youngest, these lineages comprise the following alleles: "A101/A201/O09", "B101", "O02" and "O01". The continued presence of the O alleles is hypothesized to be the result of balancing selection. Both theories contradict the previously held theory that type O blood evolved first. It is possible that food and environmental antigens (bacterial, viral, or
Jehovah's Witnesses and blood transfusions place patients at heightened risk for reduced long-term survival." The study also stated that "Survival estimates of Witnesses were 86%, 69%, 51%, and 34% at 5, 10, 15, and 20 years after surgery, respectively, vs 74%, 53%, 35%, and 23% among non-Witnesses who received transfusions." Bloodless medical and surgical techniques have limitations, and surgeons say the use of various allogeneic blood products and pre-operative autologous blood transfusion are appropriate standards of care for certain patient presentations. The Watch Tower Society states that in medical emergencies where blood transfusions seem to be the only available way to save a life, Jehovah's