[Possibilities for avoiding homologous blood transfusion in surgical interventions].

Alternative techniques to reduce the need for homologous blood transfusions are clinically available for several years. Actually a decision of our federal constitutional court (Bundesgerichtshof) outlined the medicolegal importance of autologous blood transfusion concepts. Pre-operative donation of red cells and/or plasma, acute normovolemic hemodilution, and intraoperative blood salvage and retransfusion will be discussed in terms of effectiveness, advantages, indications, and contraindications. In an emergency hemorrhage situation only the intraoperative blood salvage and retransfusion is available. The other autologous concepts are important in elective surgery.