A cost analysis of autologous and allogeneic transfusions in hip-replacement surgery

Purpose To analyze the cost consequences of autologous versus allogeneic transfusions. Methods Costs were determined when allogeneic transfusions were given in addition to, or instead of, autologous transfusions. Hospital charges were used to estimate costs for hip-replacement surgery. The main outcome measure was estimated incremental hospital costs per unit transfused. Results Among donors of autologous blood, mean total charges were $7,200 greater for recipients of both autologous and allogeneic transfusions than for recipients of autologous transfusion only (P = 0.0001). Each allogeneic transfusion was associated with additional costs of $1,480. In a second cohort of patients receiving identical amounts of either allogeneic or autologous blood (mean = 2.3 units), total hospital charges were a mean of $4,800 greater (P = 0.0001) for allogeneic recipients. The perunit excess costs associated with each unit of allogeneic blood in this cohort were $1,043. Conclusions Allogeneic transfusions are associated with incremental hospital costs of about $1,000 to $1,500 per unit transfused when compared with costs for similar patients receiving no transfusions or 1 to 5 units of autologous blood.