Autologous whole blood and platelet-rich plasma harvested intraoperatively before cardiopulmonary bypass have been used by many in an effort to reduce the use of allogeneic blood transfusions during cardiac surgery. This brief review analyses the literature published concerning those two techniques. Although theoretically appealing, neither technique appears at present to withstand close scrutiny because of limitations in the design of many clinical studies. Efforts at blood transfusion avoidance during cardiac surgery may be best directed toward the salvage of intraoperative blood (including the residual oxygenator circuit contents), selective acceptance of low haemoglobin concentrations, and prophylactic administration of antifibrinolytic drugs.