title: Intraoperative hemodilution is more cost-effective than preoperative autologous donation for patients undergoing procedures associated with a low risk for transfusion.
abstract: OBJECTIVE
  To determine the utilization and cost of autologous blood that was donated preoperatively, and to compare it to the cost of employing intraoperative hemodilution to provide autologous blood for patients undergoing surgical procedures with a low risk for the need for transfusion.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  All ASA physical status I and II patients who underwent nononcologic gynecologic procedures and preoperatively donated autologous blood between July 1993 and June 1994.
  
  
  RESULTS
  The utilization and overall cost of predonated autologous blood was determined. The cost for employing intraoperative hemodilution and potential cost saving was then calculated. Of the 234 units of preoperatively donated autologous blood, 38 units were returned to patients who had an estimated blood loss of at least 500 ml, 32 units returned to patients who had an estimated blood loss less than 500 ml, and 164 units were wasted. No patient received allogeneic blood. The estimated total cost for all preoperatively donated autologous blood was $23,274.62. Employing hemodilution for those same patients would have cost $5,574.74, and resulted in a potential 75.6% savings.
  
  
  CONCLUSIONS
  Inappropriate selection of patients for preoperative blood donation is costly. For those patients scheduled to undergo surgical procedures associated with a low probability for the need for blood transfusion, but who desire that autologous blood be available, hemodilution provides fresh whole blood, free from the possibility of processing or clerical errors, while decreasing blood bank utilization and affording substantial cost savings.
authors.affiliation: Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Rosenblatt
authors.forename: E M
authors.initials: EM
authors.lastname: Cantos
authors.forename: K
authors.initials: K
authors.lastname: Mohandas
mesh_terms: D000328:Adult; D001804:Blood Transfusion, Autologous / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D005836:Genitalia, Female / Q000601:surgery*; D006438:Hemodilution / Q000191:economics*; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk