During the last years, themain risks associated with blood transfusion have been enphasized: transmission of infections, specially after the indentification of the human immunodeficiency virus and its transmission through blood transfusion caused public concern, and other infectious agents as hepatitis C virus, HTL V-I and cytomegalovirus were added to the list of the transfusion transmissable agents. In recent years, publications about increased recurrence of certain cancer in transfused patients let to the investigators to look to the immunological effects of blood tranfusion. Keeping this risks in mind, it has been necessary to find new strategies for avoidint the transfusion of homologous blood. These strategies started with the right prescription of blood transfusion, only when the benefits are more significant than the potential risks and the development of autologous blood transfusion in its differente forms: as predeposit, acute normovolemic haemodilution and intra and postoperatory blood salvage