Version May 2024
| Unacceptable treatment |
| Transfusion of allogeneic whole blood, red blood cells, white cells, platelets, or plasma |
| Preoperative autologous blood donation (PAD or predeposit) |
| Acceptable treatment |
| Most surgical and anesthesiological blood conservation measures (eg, hemostatic surgical instruments, controlled hypotension/hypotensive hemostasis, regional anesthesia, minimally invasive surgery, endovascular therapy, intraoperative positioning, maintenance of normothermia, meticulous hemostasis and surgical technique) |
| Most diagnostic and therapeutic procedures (eg, phlebotomy for laboratory testing, angiographic embolization) |
| Synthetic oxygen therapeutics (eg, perfluorochemicals) |
| Nonblood volume expanders (eg, saline, lactated Ringer's, hydroxyethyl starches) |
| Pharmacologic agents that do not contain blood components or fractions: |
| Drugs to enhance hemostasis (eg, tranexamic acid, epsilon-aminocaproic acid, aprotinin, desmopressin, conjugated estrogens) |
| Hematopoietic growth factors and hematinics (eg, albumin-free erythropoietin, iron) |
| Recombinant products (eg, albumin-free coagulation factors) |
| Topical hemostatic agents (eg, collagen, gelatin-based hemostats, oxidized cellulose) |
| Personal decision (acceptable to some, declined by others) |
| Blood cell salvage* (intraoperative or postoperative autotransfusion) |
| Acute normovolemic hemodilution* |
| Intraoperative autologous blood component sequestration* (including intraoperative plateletpheresis, preparation of fibrin gel, platelet gel, platelet-rich plasma) |
| Cardiopulmonary bypass¶ |
| Apheresis¶ |
| Hemodialysis¶ |
| Plasma-derived fractions (eg, immune globulins, vaccines, antivenins, albumin, cryoprecipitateΔ) |
| Hemostatic products containing blood fractions (eg, recombinant factor VIIa◊, coagulation factor concentrates, prothrombin complex concentrate, fibrin glue/sealant, hemostatic bandages containing plasma fractions, thrombin sealants) |
| Products containing plasma-derived blood fractions such as human serum albumin (eg, some formulations of erythropoietin, streptokinase, granulocyte colony-stimulating factor [G-CSF], vaccines, recombinant clotting factors, nuclear imaging products) |
| Oxygen therapeutics and other products containing a blood cell-derived fraction, whether from a human or animal source (eg, conjugated hemoglobin solutions, iron supplements, hematin, interferon alfa-N3 [leukocyte derived]) |
| Epidural blood patch |
| Blood cell scintigraphy (eg, radionuclide tagging for localization of bleeding) |
| Peripheral blood stem cell transplantation (autologous or allogeneic) |
| Transplants (organ, marrow, bone) |
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