Autologous Blood Predonation Versus Acute Normovolemic Hemodilution

Abstract

SUMMARY Autologous blood donation is a standard of care for elective surgical procedures requiring blood transfusion. Preoperative autologous blood donation (PAD) and acute normovolemic hemodilution (ANH) are both recommended autologous blood procurement strategies that reduce the need for allogeneic blood transfusions. Limitations of PAD include a high wastage of donated blood and poor cost-effectiveness. In addition, this technique promotes preoperative anemia and a liberal transfusion policy. ANH is a “point-of-care” strategy that can be performed in the operating room, thereby decreasing the cost and wastage of blood. Clinical studies have demonstrated that PAD and ANH have similar efficacy and outcomes in urologic surgery. However, studies comparing these techniques in orthopedic surgery are equivocal. Cost comparisons have demonstrated that ANH is a less costly blood procurement technique than PAD. Additional clinical trials are necessary to further define the role for these autologous blood conservation modalities.