Authors' objectives:

This report aims to assess the value and cost-effectiveness of preoperative autologous blood donation (PABD).

Authors' recommendations: Studies suggest that while PABD decreases, it does not totally eliminate, the need for allogeneic transfusion for elective surgery. However, it does greatly increase the likelihood of any transfusion and is not entirely without medical risks. Medical risks associated with autologous donation, from dizziness to anemia to the possibility of angina (and even cardiac arrest), should be considered when high-risk patients are referred for preoperative autologous collection. It is possible that the wrong blood, either allogeneic blood or another patient's autologous blood, may be given to the PABD donor or another patient Only about two-thirds of all autologous blood units collected are actually used, and the cost per life-year-saved is higher than the benchmark cost for most medical and surgical interventions. As the safety of the American blood supply continues to improve, the possible clinical benefit of autologous blood donation becomes diminished. PABD should be discontinued as a routine medical practice due to the current high degree of safety of the U.S. blood bank supply, as well as due to the inherent medical risks associated with PABD. This recommendation becomes of even increasing clinical importance since new blood bank testing procedures, and new means of treating and handling allogeneic blood units, are being developed and implemented on an ongoing basis. Blood transfusion requires the informed consent of patients, and the medical risks and benefits of both autologous and allogeneic blood transfusion need to be discussed in detail by physicians prior to elective surgery. It is important during such discussions to reserve the encouragement of PABD for patients who, in the physician's professional opinion, have a real and obvious medical requirement for electing PABD. Allogeneic blood units should be transfused whenever clinically appropriate. Physicians should discuss the medical risks and costs associated with PABD in detail with their patients before encouraging the use of PABD.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.health.state.mn.us/htac/pabd.htm

Year Published: 2000

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Health Technology Advisory Committee

Contact Address: Queries should be referred to the Minnesota Department of Health (http://www.health.state.mn.us/)

Copyright: Health Technology Advisory Committee