Blood loss during radical retropubic prostatectomy: Is preoperative autologous blood donation indicated?

Purpose: We assessed the requirement for transfusion of allogeneic blood in a contemporary series of patients who did not deposit autologous blood before radical retropubic prostatectomy. Materials and Methods: After a policy was adopted in which preoperative autologous blood was not donated, 124 consecutive patients underwent radical retropubic prostatectomy. Type and screen for allogeneic blood were routinely available but neither hemodilation nor a cell saver was used. Results: Mean intraoperative blood loss was 579 cc and mean postoperative serum hematocrit was 33%. Only 3 patients (2.4%) required blood products due to intraoperative blood loss (2) and postoperative bleeding from a duodenal ulcer (1). Conclusions: Transfusion of blood products was required in a small percentage of our patients even without autologous blood donation. Therefore, the overall cost of care is decreased but, more importantly, the potential risks associated with autologous or allogeneic blood transfusion are eliminated.