[Autologous transfusion and its use in clinical practice]

Autologous transfusion is the reinfusion of a patient's own blood. Increased awareness of the risks of homologous transfusion, primarily transfusion transmitted infections has caused patients and physicians to search for safer alternatives. One promising alternative is autologous transfusion, generally accepted as the safest form of transfusion. Current strategies of autologous transfusion include preoperative collection of autologous blood, intraoperative salvage of autologous blood, postoperative salvage of autologous blood and acute normovolemic haemodilution. Preoperative collection is performed to ensure the patient's blood for elective surgical procedures. Intraoperative salvage consists of aspirating blood from surgical fields or other sterile bleeding sites, and returning this blood to the patient. Postoperative blood salvage is retrieval of blood shed within the first 24-48 hours postoperatively in patients who are actively bleeding, usually after cardiopulmonary bypass procedures. Acute normovolemic haemodilution is the rapid removal of blood and simultaneous replacement with cell-free fluid. It appears likely that combination of various autologous transfusion strategies is necessary for the successeful functioning of autologous transfusion programme.