Blood Donation Before Surgery

Should I donate my own blood before an operation?

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When faced with major surgery, you may have concerns about the risks of blood transfusions. One way to make it safer is with a preoperative autologous donation (PAD), in which your blood is collected before surgery and given back to you during or after surgery if you should happen to need it.

Medical worker holding a bag of blood
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The reasons for a preoperative autologous donation can vary. In some cases, PAD is recommended for surgeries in which blood loss is expected to be high. Other times, it may be done due to other medical concerns. Some people choose PAD to avoid bloodborne infections and other risks, both real and perceived.

However, this procedure is really only necessary in a few instances and isn't without risks.

Surgery With High Blood Loss

Blood loss is a common part of surgery, and while every effort is made to minimize the loss, in certain surgeries it cannot be avoided.

When blood loss is anticipated to be greater than 20%, PAD may be recommended. This not only ensures an ample blood supply if you need it but also alleviates stress on the community blood supply.

Surgeries in which excessive blood loss is common include:

If you decide to pursue PAD, you'll likely make the donation three to five weeks before your scheduled surgery. That gives your body time to replenish much of the lost blood.

If less than 10% of blood is expected to be lost during surgery, an allogeneic blood transfusion (in which blood is donated from another person) is recommended.

Other Medical Reasons

Anticipated blood loss is only one of the reasons that PAD is used.

If you have a rare blood type, you may face situations in which the local supply just isn't adequate for your needs, making PAD an attractive option.

PAD also may be a good idea if you have an autoimmune disease. If you receive someone else's donated blood, your immune system may attack and destroy the blood cells. This is called a hemolytic transfusion reaction.

The surgical team can take steps to reduce your risk of a transfusion reaction if you do need to receive donated blood.

Risks of Disease Transmission

Historically, some people have chosen PAD to avoid the transmission of bloodborne diseases. This was especially true in the early- to mid-1980s, when reports came out saying people had been infected with HIV from blood transfusions.

Many hepatitis C infections were also acquired from blood transfusions performed before the viral cause was officially identified in 1989. The perceived risk of a blood transfusion can often exceed the actual risk, particularly with regard to bloodborne infections.

Despite fears of infection from HIV, hepatitis C, and other diseases, transfusions in the United States are considered safe and pose little risk of such transmission.

Since the advent of universal blood screenings in the late 1990s, the risk of acquiring HIV from blood transfusions has dropped to one in every 1.8 million procedures. In fact, the U.S. saw only three confirmed cases of HIV from a blood transfusion between 1999 and 2003.

Similarly, the risk of hepatitis C from contaminated blood is less than one in every two million procedures, according to a 2014 review of studies in the journal Transfusion.

Beyond the risk of infection, the chances of receiving incompatible blood (in which you are given the wrong blood type) are extremely rare in the U.S. and considered a "never event" in the United Kingdom.


PAD is generally considered safe, with only mild, short-term side effects, including minor bleeding, pain, bruising, fatigue, and lightheadedness.

Still, PAD is typically avoided in people with certain pre-existing medical conditions because the loss of blood before surgery may have serious consequences. These conditions include:

PAD is also avoided in people with known or suspected bacteremia (bacteria in the blood). Bacteria in the donated blood can multiply as the blood awaits reinfusion, increasing the risk of septicemia (blood poisoning) and sepsis.

A Word From Verywell

Although receiving your own blood may put your mind at ease, preoperative autologous donations are really only considered if there's a local blood shortage and/or your anticipated blood needs after surgery are high.

If you have concerns about the risks of blood transfusion or are curious about the benefits of PAD, bring it up with your surgeon.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. Engle RE, Bukh J, Alter HJ, et al. Transfusion-associated hepatitis before the screening of blood for hepatitis risk factors. Transfusion. 2014;54(11):2833-41. doi:10.1111/trf.12682

  6. Centers for Disease Control and Prevention. HIV transmission through transfusion - Missouri and Colorado. MMWR. 2010; 59(41);1335-9.

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By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.