Autologous blood transfusion: evaluation of an alternative strategy in reducing exposure to allogeneic blood transfusion.

The perceived risk of transfusion-transmitted disease led to the rejuvenation of autologous blood transfusion (ABT). ABT, a process in which the blood donor and recipient are the same, is increasingly becoming an integral component of the elective surgical protocol in many institutions. Various methods of ABT are being utilized. These include: preoperative blood donation, in which the patient donates blood prior to surgery and the blood is stored for an expected need during or after surgery; acute normovolemic hemodilution, in which blood is collected immediately prior to surgery and replaced with cell free fluids and then returned to the patient upon need; intraoperative blood salvage in which blood is collected from the surgical field and is reinfused after being washed and finally, postoperative blood salvage in which collected shed blood from surgical drains is reinfused to the patient. Although ABT is known to reduce the risk of allogeneic blood transfusion, it is not risk free and should be evaluated in relation to the patient's clinical picture. The combination of various methods of ABT in addition to the proper utilization of blood may consequently lead to the elimination of patients' exposure to allogeneic blood transfusion in many surgical procedures.