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Preoperative autologous blood donation (PABD) is the donation of the patient's own blood before surgery for use in planned surgical procedures. Appropriate patients for this form of blood conservation are those having elective surgery for which blood is usually transfused, whose hemoglobin is no less than 11 g/dL, and who display no signs or symptoms of bacteremia. Patients should begin donation 4–6 weeks before surgery, donate every 3–7 days, take oral iron, and donate the last unit more than 72 hours before surgery. Vesovagal reactions occur in 2–5% of donors. In this article, the authors review indications and associated risks of PABD. Also discussed are segregated processing, testing, disposition of unused units, platelet-rich plasma, recombinant erythropoietin, indications for autologous versus allogeneic transfusion, and cost-effectiveness of preoperative autologous blood donation. Nurses play important roles in PABD. Provision of information to patients regarding when, where, and how autologous donations are made along with prevention of errors in blood availability and transfusion are discussed. Nursing and blood bank staff members must establish regular communication to ensure the provision of a quality PABD program.