[The "concept of autologous transfusion"]

This study analyzes the need for homologous blood in a prospectively studied group of 4,357 orthopedic-surgical patients after having established the 'Concept of Autologous Transfusion' (CAT) in 1989, in comparison to a retrospectively studied group of 7,485 orthopedic-surgical patients that had been treated exclusively with homologous blood (in 1986 and 1987). Despite an increase by 18% of the number of operations performed (in 1986: 3,698 operations vs. 4,357 operations in 1989), the need for homologous blood has been reduced by more than 80% (in 1986: 12,600 units of homologous packed red blood cells vs. 1989: 2,145 units of homologous blood). This effect has been achieved by the combination of various blood-saving techniques, namely by normovolemic hemodilution in 3,591 patients (82.4%), intra- and post-operative blood salvage in 1,936 patients (44.4%) as well as by 2,261 preoperative autologous blood donations, and by 5,279 preoperative plasmaphereses. Preoperative autologous donations have been accompanied by side effects in 1.3% (mild and moderate); no serious or even fetal complications occurred and all ambulatory patients coming to the hospital just for an autologous donation left for home on the same day.