Modern anticoagulants only allow blood storage 21 to 42 days. All autologous units must be tested for ABO and Rh. Physicians should become acquainted with facility protocols. Because preoperative autologous units require special handling and tracking, most facilities charge an additional autologous fee. Donors may want to contact their insurance carriers for questions about covered expenses.
Some anesthesiologists hemodilute their patients immediately before surgery.
While preparing a patient for surgery, they may withdraw 1-2 units of fresh whole blood and replace this volume with IV fluids. The units of blood are given back to the patient as needed for blood loss during or immediately after surgery with no additional testing. This protocol reduces the need to use someone else's blood for transfusion. It also reduces the total red cell mass lost during surgery since the blood is diluted with IV fluids. However, only a limited number of units can be collected this way and not all patients can tolerate such changes in blood volume.