Cost‐effectiveness of Autologous Blood Predonation

SUMMARY The diminishing risks of allogeneic transfusion and the recognition of limited health care budgets cast doubt on the value of preoperative autologous blood donation (PABD). The criteria for estimating the alleged benefit of PABD are provided by the discipline of clinical epidemiology and are referred to as efficacy, effectiveness and efficiency. The efficacy of PABD can be assumed for colorectal cancer surgery, hip replacement and liver resection. PABD may be efficacious in most other elective surgical interventions with significant, anticipated blood loss. PABD is effective in these cases if there is no significant risk of donation or if a high statistical or individual risk of allogeneic transfusion isto be prevented. PABD is probably efficient, i.e. cost‐effective, if additional conditions such as low patient age, low production cost and/or high transfusion probability additionally apply. Production costs can be reduced by storing and delivering autologous blood as whole blood without harm to the patient.