The Late Donation of Autologous Units Increases Allogeneic Transfusion Requirements

The benefits of autologous transfusion are evident. However, rapid escalation of this practice has caused unnecessary collection of autologous blood before low-risk elective surgery. Because overcollection is costly and time consuming and involves some health risks to the patient, this practice should be avoided. Generation of a schedule for optimal preoperative collection of autologous blood is suggested to maximize safety while minimizing cost. Whenever possible, restricting the last autologous blood donation to more than 14 days prior to surgery appears to be the best way to avoid homologous transfusion. Given the improved safety of allogeneic transfusion today, the rationale for autologous blood donation, which was firmly based on the prevention of transfusion-transmitted infection, is less compelling than it was a decade ago.