Predictors for the need of blood transfusion were analyzed using multiple regression analysis in 1689 patients undergoing elective major abdominal surgery before the age of 80 years and with a preoperative blood hemoglobin concentration above 110 g/L. Rectal surgery for malignant disease and pancreatic surgery (for malignant or benign disease) were associated with higher transfusion requirements (mean 2.4 units) than other operations (0.6 units). If two autologous units had been available in-these patients, the fraction needing allogeneic transfusion could have been reduced from 59% to 31%. It would not be effective to predonate more than 2 units. For other types of surgery the rate of allogeneic transfusion would not have been much reduced, and most autologous blood would have been wasted.
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