Public concern about the risk of transfusion-transmitted disease, especially acquired immunodeficiency syndrome, has resulted in unprecedented growth in autologous blood donation programs.1 In addition to eliminating transfusion-transmitted viral diseases, the use of autologous blood transfusion avoids the risk of sensitization to red blood cell antigens and subsequent antibody formation. Although there are many published studies that illustrate both the effectiveness and safety of such programs,2-4 there are comparatively few that specifically address the pediatric patient.
Autologous transfusion is defined as the collection and reinfusion of a patient's own blood. This may be accomplished by one of three modalities: (1) preoperative blood donation with subsequent blood bank storage and reinfusion during or following surgery; (2) acute normovolemic hemodilution, whereby blood is collected immediately preceding or following anesthetic induction and reinfused at the end of the surgical procedure; and (3) intraoperative and postoperative blood salvage, whereby blood shed into the operative field or enclosed space is collected, washed, and reinfused during or after surgery.