Prevention of transfusions

Because of widespread concern about the risks of allogeneic blood transfusion, clinicians and investigators have developed a multipronged approach to limiting risk. Improved diagnostic screening tests have dramatically reduced the incidence of blood products from virally infected donors. Acceptance of lower 'transfusion triggers' has reduced the perceived number of situations in which transfusion is considered necessary. Other techniques have also contributed to reduced numbers of allogeneic transfusions, including autologous preoperative blood donation, perioperative red cell salvage, acute intraoperative normovolemic hemodilution, deliberate hypotension, and development of pharmacologic adjuvants and of blood substitutes.