THERE is a growing interest in alternatives to homologous transfusion provided by volunteer donors. Autologous transfusions are increasingly in demand and some patients choose their own donors from among family and friends, a practice called recipient-selected transfusions or directed donations.
Providing autologous transfusion for selected patients is medically sound. Patients who can safely donate for their own transfusion needs reduce their exposure to infectious disease. In contrast, no role has been established for directed donations in reducing the infectious complications of transfusion. An assessment of the risk of infection is particularly important, bearing in mind that autologous and directed donations, when not used by their intended recipients, are potentially available for the general blood supply. The number of donations available may be considerable, especially as many autologous collections are inappropriately made to cover elective surgery procedures that seldom require blood.1
The practice of "crossing over" unused directed donor and