Autotransfusion: an impossible dream?

Despite the many critics of autologous blood transfusion, there is virtually no literature to support such an attitude in relation to any form of premeditated autologous blood transfusion. It is only in relation to intraoperative blood scavenging that there have been complications. In contrast, there is considerable literature supporting the theoretical and practical advantages of autologous transfusion and haemodilution and a wealth of evidence pointing to the immediate and delayed complications of homologous transfusions. In this paper autologous blood transfusion is reviewed with particular emphasis on the factors responsible for its failure to achieve a widely accepted place in clinical medicine despite its theoretical, practical and economic advantages.