The letter by Dr Semchyshyn directs attention to the potential for autologous and directed units being used to diminish the need for altruistic community donors. Their usefulness in the general blood supply is limited by the substandard hemoglobin that many autologous units will have and the holding of both autologous and directed units until it is clear that the recipient will no longer need the blood. Some institutions consider the intended recipient to "own" the unit and require a written release.The more fundamental question is relative safety. Clearly, autologous donors are motivated by concern for their own welfare rather than that of the community. Therefore, it is difficult to conduct the donor interview to be certain that the blood can be "crossed over" to other patients if the intended recipient does not need it. The details of separating such units can become complicated and, as a practical
Toby L. Simon. Postpartum Blood Requirements and Autologous Donation-Reply. JAMA. 1988;260(11):1556. doi:10.1001/jama.1988.03410110064028
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