Use of blood products during elective cholecystectomy

To determine the value of preoperative blood typing and crossmatching, we reviewed the transfusion needs of 100 consecutive patients who had elective cholecystectomy in a city-county teaching hospital. One hundred forty-eight units of blood were typed and crossmatched for 76 patients (1.48 units/patient). Blood was typed and screened for seven patients. Six units were transfused into four patients (two patients postoperatively). None required intraoperative transfusion for hemorrhage or shock. Total blood use was 4%, with a mean of 0.06 units per patient. Substituting the type and screen for a type and crossmatch would have saved approximately $2,108 and 16.6 technician hours in this group and, if applied nationally, $9 million and 72,000 technician hours each year. In addition to sizeable savings, more efficient blood use would result from use of the type and screen in elective cholecystectomy, with no increase in patient risk.