[How Much Blood and What Components does the Patient need Intra- and Perioperatively?].

Area of Science:

• Clinical Transfusion Medicine
• Immunohaematology
• Haemostaseology

Background:

• Increased availability of blood products has enabled more surgeries but can cause adverse postoperative effects via immunomodulation, requiring restrictive transfusion indications.
• Demographic changes, including a shrinking donor pool and an aging population with higher blood product needs, create supply challenges.
• Rising costs of red blood cell packs, particularly for blood group O and Rh-negative units, further emphasize the need for efficiency.

Purpose of the Study:

• To review current advancements in clinical transfusion medicine, immunohaematology, and haemostaseology.
• To highlight the impact of these advancements on daily transfusion practices.
• To emphasize blood-sparing measures, particularly patient blood management.

Main Methods:

• Narrative review of recent findings in transfusion medicine, immunohaematology, and haemostaseology.
• Focus on patient blood management strategies: preoperative iron substitution and structured assessment/management of coagulation disorders.
• Discussion of ongoing prospective studies to determine optimal transfusion triggers and consideration of patient/donor-specific factors.

Main Results:

• Patient blood management is presented as a key blood-sparing strategy.
• Evidence is provided on optimizing iron substitution and managing coagulation disorders.
• Consideration of blood group-dependent features for rational haemotherapy is discussed.

Conclusions:

• There is a critical need for blood-sparing measures due to demographic shifts, increased demand, and rising costs.
• Patient blood management, encompassing iron management and coagulation optimization, is vital for effective transfusion practice.
• Further research into transfusion triggers and patient/donor factors is essential for evidence-based haemotherapy.