Cost effectiveness of autologous blood donation

To the Editor: The bleak conclusions that Etchason and colleagues offer about the limited usefulness and high costs of autologous blood donation (March 16 issue)¹ seem premature and unwarranted. The ability to test and eliminate most donors with hepatitis B or C or the human immunodeficiency virus (HIV) is an important advance but does not ensure a completely safe blood supply. Just this year, new hepatitis viruses have been identified²; at least one is transmitted through blood transfusion (Alter HJ: personal communication). Many additional bacterial, viral, and protozoal infections are problems, and other complications of allogeneic blood transfusion are.