Reducing the burden of anaemia for people undergoing major surgery

Pathways and a culture that view blood as disposable must yield to approaches that value patients’ own blood

The often predictable haemostatic challenge of surgery includes the possibility of anaemia increasing procedure‐induced stress and consequently the burden on the patient during the operation and their recuperation. Peri‐operative anaemia has often been managed by transfusion. Blood was regarded as disposable, and the ready supply of donor blood has enabled higher risk invasive procedures in the knowledge that blood can be replaced even in the event of excessive loss. Despite considerable advances in the safety of transfusion, blood remains a biological product with residual risks, including infection and immunological effects. Further, each unnecessarily transfused unit of blood increases the burden on donations.