Anesthesia & Analgesia, Vol 83, 129-133, Copyright © 1996 by International Anesthesia Research Society
A cost comparison of allogeneic and preoperatively or intraoperatively donated autologous blood
WA Roberts, SA Kirkley and M Newby
University of Rochester Medical Center, New York, USA.
We determined the cost of allogeneic packed red blood cells and autologous
whole blood donated either preoperatively or in the operating room during
hemodilution. Direct and indirect cost estimates were based on patients
requiring simple transfusion and included procurement and preparation of
the blood including testing performed, materials and time used, waste, and
materials for administration. Data were derived from prospective blood bank
time studies, material invoice records, and retrospective review of
anesthesia times. Viral infection and transfusion reaction costs were
accepted from previously published sources. Direct cost of purchasing and
indirect costs of preparation resulted in an overall cost of $107.26 for
the first unit of allogeneic packed red blood cells transfused. A second
unit was slightly less costly ($100.89), as no type and screen was required
and the same delivery set and filter can be used. The total cost of
acquisition, processing, and transfusion 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 $83.10. These data suggest that autologous
predonation of whole blood is somewhat less expensive than allogeneic
packed red blood cells, and that hemodilution may be a cost effective
alternative to autologous predonation in selected patients.
