Hemotherapy in elective surgery: an incidence report, review of the literature, and alternatives for guideline appraisal.

The growing demand upon existing reserves of blood requires a more efficient use of this limited resource. Numerous regional medical centers have shown the current practice of type and crossmatch to be highly inefficient, whereas the proven, safe type and screen method for reserving blood units effectively increases the available blood pool and decreases costs of maintaining a blood bank. Approaches other than the crossmatch to transfusion ratio are proposed to provide objectivity for establishing procedures to be converted to type and screen and the appropriate number of units for patients requiring a type and crossmatch. Cumulative blood ordering recommendations are provided.