Yomtovian R
Institute of Pathology, Case Western Reserve University, Cleveland, OH, USA.
Am J Clin Pathol. 1997 Apr;107(4 Suppl 1):S28-35.
Autologous transfusion, which is widely endorsed as the safest transfusion practice, has undergone rapid-and often unchecked-growth since the mid-1980s, primarily in response to the recognition of transfusion-associated HIV. Substantial improvements in blood transfusion safety, combined with the increasing emergence of managed care during the past decade, have spurred a reexamination of autologous transfusion and its ability to provide increased transfusion safety in a cost-effective manner. The ultimate utility of preoperative autologous donation and transfusion depends on whether (1) waste is limited by the development of meticulously crafted benchmarks for appropriate surgical applications, (2) donor-patient risk is limited by careful donor selection and scheduling and scrupulous attention to iron supplementation, (3) strategies are identified to enhance cost-effectiveness, and (4) policies and procedures are developed to reduce or prevent accidents and errors.
自体输血被广泛认为是最安全的输血方式，自20世纪80年代中期以来经历了快速且往往未经核查的增长，主要是为了应对输血相关艾滋病病毒的发现。输血安全性的大幅提高，加上过去十年中管理式医疗的日益兴起，促使人们重新审视自体输血及其以具有成本效益的方式提高输血安全性的能力。术前自体献血和输血的最终效用取决于以下几点：（1）是否通过为适当的手术应用制定精心设计的基准来限制浪费；（2）是否通过仔细的献血者选择和安排以及对铁补充的严格关注来限制献血者-患者风险；（3）是否确定提高成本效益的策略；（4）是否制定政策和程序以减少或预防事故和错误。
