Benefits and risks of scheduled autologous blood transfusion

Blood transfusion, like any other medical activity, requires an analysis of the risk/benefit ratio for each patient. Autologous blood transfusion does not escape this golden rule. The benefits expected of scheduled autologous transfusion consist of the reduction of the risks inherent in homologous transfusion. Those benefits are indisputable in erythrocyte alloimmunisation and viral or parasitic disease transmission. But the risks attached to such protocols have often been underestimated. The risks for the patient are still linked to the transfusion of autologous labile blood products (haemolysis, bacterial infections) or to consequences of whole blood donations (cardiovascular intolerance, increased use of transfusion, increased operative bleeding). There are also risks for the patient community insofar as autologous blood products which do not all meet the same criteria of clinical and biological validation as homologous blood products are circulated in care institutions. (C) 1998 Elsevier, Paris.