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 and other blood-borne infections, or immune system reactions. Many physicians have expressed a willingness to respect patients' preferences and provide bloodless treatment and about 200 hospitals offer bloodless medicine and surgery programs for patients who wish to avoid or limit blood transfusions. Bloodless surgery has been successfully performed in significant procedures including open-heart surgery and total hip replacements. A 2012 study in "JAMA Internal Medicine" concluded that "Witnesses do not appear to be at increased risk for surgical complications or long-term mortality when comparisons are properly made by transfusion status. Thus, current extreme blood management strategies do not appear to