The Cost Effectiveness of Preoperative Autologous Blood Donations

Published In: New England Journal of Medicine, v. 332, no. 11, Mar. 16 1995, p. 719-724

Posted on RAND.org on January 01, 1995

by Jeff A. Etchason, Lawrence D. Petz, Emmett B. Keeler, Loni Calhoun, Steven Kleinman, Cynthia Snider, Arlene Fink, Robert H. Brook

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A patient makes an autologous blood donation prior to surgery so that his or her blood can be reinfused if it is needed during surgery. The value of this process is that the patient does not receive someone else's blood, which could conceivably carry a contagious disease. A decision-analysis model assessed the cost-effectiveness of donating autologous blood for four surgical interventions. Results indicated that substituting autologous for community blood resulted in little expected health benefits at considerable additional cost. The additional cost was primarily a function of discarding the units that were donated but not transfused and of a more labor-intensive donation process (autologous donors are typically less healthy than regular donors, and so take longer to give blood). The authors conclude that, given the improved safety of allogeneic transfusions, the increased protection afforded by donating autologous blood is limited and may not justify the increased cost.

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