Abstract
Why has the use of preoperative autologous blood donation (PAD), which markedly increased in the 1980s and early 1990s, been declining recently?1 The short answer is that PAD is no longer thought to be cost-effective principally because of the virtual elimination of hepatitis and human immunodeficiency viruses from the donor blood pool. This perception is supported by an economic evaluation published in the New England Journal of Medicine, which found that in cardiac surgery the cost of PAD per quality adjusted life year was approximately US$500,000.
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