[Experience with a blood component program in surgical hemotherapy].

Within the component concept applied during the past 6 years at the University Hospital in Berne (Switzerland), 85% of all red cell units are transfused as concentrates with a hematocrit of 70%, and the remaining 15% as fresh whole blood. The rationale in surgical patients is to exploit the different "critical levels" of the blood volume, hematocrit, total serum protein, plasmatic coagulation factors, and platelets. A colloid plasma substitute compensating for the plasma deficit of the red cell concentrates is an integral part of the system. A carefully checked, retrospective study in 372 patients revealed no disadvantages for the postoperative course. During the first 4 1/2 years after its introduction it did not increase the demand for human plasma protein solutions. With the red cells as a pacemaker for the number of blood donations, this system can simultaneously cover a reasonable national demand for albumin and factor VIII.