Cost comparison of intraoperative autologous versus homologous transfusion.

The cost of autologous transfusions using semiautomated instruments in 52 orthopedic cases, 75 coronary artery bypass graft (CABG) cases, and 218 aortic aneurysm cases was compared to the cost of equal amounts of homologous blood. While none of the orthopedic cases reached cost equivalence (median cost deficit per case, +97), 31 percent of the CABG cases (median cost deficit per case, +61) and 56 percent of the thoracic aortic aneurysm cases (mean cost surplus per case, +30) did so. In most cases, the major orthopedic and CABG procedures do not reach cost equivalence and might be served better by other means of autologous blood recovery. The more expensive semicontinuous flow devices are more cost-effective for higher-yield cases, such as major aortic aneurysm procedures.