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 per-unit 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.