Transfusion of autologous blood, recovered from the surgical field, has been widely accepted for use in elective cases with significant blood loss. The use of these techniques in the setting of exsanguinating traumatic haemorrhage has been limited, however, by a number of confounding issues. These include: (a) the potential for increased infectious complications resulting from the reinfusion of blood from a contaminated field; (b) the risk of exacerbating a consumptive coagulopathy; (c) a potential increased risk of multiple organ failure syndrome due to the infusion of cytokines and activated inflammatory mediators; (d) the practicality and logistics of this approach in the moribund patient; and (e) the cost-effectiveness of this technology. The purpose of this review is to evaluate the current literature addressing these issues and better define the role for autologous transfusion in the trauma population.
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