The value of autotransfusion in the management of intraoperative blood loss during orthopedic surgery.

The principal advantage of autologous blood transfusions is the danger of transmitting infectious agents and the adverse immunomodulatory effects of allogenic transfusion can be avoided. The effectiveness of preoperative autologous blood donation in reducing allogenic blood exposure is undisputed. The current discussion focuses on cost effectiveness versus the potential risks of autologous blood donation, and on transfusion criteria for autologous versus allogenic blood. The cost effectiveness of autologous blood donation may indeed be low, mainly due to the high percentage of units discarded. On the basis of current literature, the authors describe various types of autotransfusion, current opinions the regarding benefits and risks of autotransfusion, and some of the economic aspects of autotransfusion.