Current problems with autologous blood supply.

OBJECTIVE The purpose of the present study consists in an updated review of recent progress in the field of autologous blood supply. At different medical centers, autologous blood products are collected by quite different procedures, which may be applied during pre-, intra- and/or postoperative periods according the technical possibilities of the local blood supply systems. The products are very different, consisting in whole blood, red cell concentrates, platelet concentrates, fresh-frozen plasma (from whole blood and from plasmapheresis), as well as in wound and drainage fluid and in washed red cell concentrates. Iron therapy against autologous blood donation--or against surgical bleeding-induced anemia--is now well established, but it is unclear whether it should be given perorally or intravenously. In addition, erythropoietin substitution may be necessary for some but not all patients. DATA SOURCES For our review we have used as sources, beyond our own published reports, studies devoted to clinical experience as well as to pathophysiological aspects of blood donation. RESULTS AND CONCLUSIONS It becomes apparent that the practice of autologous blood supply has now reached peripheral hospitals not affiliated with bigger medical centers. Smaller hospitals may share expensive equipment necessary for autologous blood collection. Such progress contrasts with persistent uncertainties regarding iron and erythropoietin substitution.