Reducing perioperative blood use
Conserving blood makes sense because supplies are limited and transfusion carries risks. Robert Choa and Siobhan Leith discuss the options
Producing blood components costs the UK National Health Service 500m pound (700m euro; $1bn) a year,1 and each unit costs about 120 pound. In all, 2.5 million units are donated a year.2 This article considers transfusion of red blood cells, rather than other blood products. Although there are risks associated with transfusing blood (box 1), it can save lives and improve patients' health. It is most often used in the following circumstances:
Patients with acute heavy blood loss after an injury or operation
Patients with symptomatic anaemia-for example, a low haemoglobin concentration regardless of cause combined with dyspnoea, fatigue, or angina, especially in patients with pre-existing cardiac disease
Patients who have specific haematological diseases (such as sickle cell disease) or bone marrow suppression.
Blood is becoming an increasingly scarce and valuable resource. Shortages occur periodically because of a fall in supply. Our increasing knowledge of variant Creutzfeldt-Jakob disease (vCJD) transmission