Autologous blood programs: what is happening?

Preoperative autologous blood collection has been advocated for many years and has seen increased application following the AIDS epidemic. Such autologous programs have been both applauded and criticized in recent years with little information available regarding actual application.

One hundred and fifty-five of the largest hospitals in the province of Ontario received surveys assessing the demographics, logistics and funding of autologous blood programs available to them. Results, a total of 78 hospitals replied, indicating that 77 sites had access to an autologous program with 26 sites having a program within their hospital. The local blood provider, Canadian Blood Services (CBS), provided access to autologous donations either alone or to the hospital in 62 sites. Three hospitals operated the program entirely on their own. Fifteen hospitals had no access to an autologous program at any site. Programs were funded in a variety of ways including patient fees in five hospitals.

In the largest Canadian province the autologous blood programs are highly variable with service not provided at all in some regions whereas in others there is a very active program often involving Canadian blood services either as a stand-alone or hospital integrated supplier. This variation in activity of the autologous program is in marked contrast to those for whole blood and apheresis collections where great standardization, through the CBS is the norm.