Surgery and blood transfusion

: Advances in surgery and the extension of the surgical indications have amplified the problems due to hemorrhage, main side effect, and its treatment, which in the past consisted primarily in whole blood transfusion. Such practice, however, involves the surgeon in a series of problems due to shortage of blood donors, religious beliefs and most of all the risks related to the transfusion practice itself. Apart from early and late reactions, the risk of transmission of infective diseases, post-transfusional immunodepression and legal problems must be pointed out. Recently, to solve these problems, the indications to blood transfusion have been restricted to severe hypovolemic shock and severe untreatable hypoxia; the separate use of blood components has been privileged; and autologous blood transfusion techniques like pre-deposit for donation, normovolemic preoperative hemodilution and intraoperative autologous transfusions have been used. It's mandatory that the surgeon keeps in date with the Transfusional Medicine progresses working in strict collaboration with the Transfusional Services to best protect the good health of the patients he has in care.