Transfusion medicine in the preoperative period

Consumer demand has significantly affected transfusion medicine. This is exemplified by the development of autogeneic and directed-donor blood programs as ways of avoiding the problems associated with allogeneic transfusions. Although the risk-benefit ratio for autogeneic blood may be favorable, the cost-effectiveness is not convincing and will be closely scrutinized in the future as we strive to find ways to provide quality, cost-effective care in this new millennium of health care.