A COST COMPARISON OF ALLOGENEIC AND PREOPERATIVELY OR INTRAOPERATIVELY DONATED AUTOLOGOUS BLOOD

We determined the cost of allogeneic packed red blood cells and autolo gous whole blood donated either preoperatively or in the operating roo m during hemodilution. Direct and indirect cost estimates were based o n patients requiring simple transfusion and included procurement and p reparation of the blood including testing performed, materials and tim e used, waste, and materials for administration. Data were derived fro m prospective blood bank time studies, material invoice records, and r etrospective review of anesthesia times. Viral infection and transfusi on reaction costs were accepted from previously published sources. Dir ect cost of purchasing and indirect costs of preparation resulted in a n overall cost of $107.26 for the first unit of allogeneic packed red blood cells transfused. A second unit was slightly less costly ($100.8 9), as no type and screen was required and the same delivery set and f ilter can be used. The total cost of acquisition, processing, and tran sfusion of 1 U of preoperatively donated autologous blood was $97.83. The total cost of a 2-U transfusion of autologous whole blood donated in the operating room during acute normovolemic hemodilution was $83.1 0. These data suggest that autologous predonation of whole blood is so mewhat less expensive than allogeneic packed red blood cells, and that hemodilution may be a cost effective alternative to autologous predon ation in selected patients.