There are numerous contraindications to the use of an autotransfusion. The presence of a coagulopathy regardless of its etiology or when it occurs (i.e., in the Emergency Department, preoperative, intraoperative, or postoperative) or evidence of disseminated intravascular coagulopathy (DIC) may be more optimally managed with the administration of specific blood component therapy. Evidence or suspicion of serious infectious processes (e.g., mediastinal, pericardial, respiratory, or systemic) precludes the use of an autotransfusion. Do not autotransfuse blood if there is the presence of a malignant neoplasm at collection site (i.e., abdominal or chest cavity) that can lead to possible contamination of the blood with malignant cells. Do not autotransfuse blood which is collected from a potentially contaminated abdominal or thoracic cavity (e.g., esophageal tear). Do not autotransfuse from a cavity that was irrigated with a solution that can cause lysis of red blood cells prior to blood collection and potentially precipitate end-organ damage if the salvaged product is administered. This includes sterile water, hydrogen peroxide, alcohol, hypotonic irrigation solutions, or povidone-iodine antiseptic gels or solutions. Blood collected from body cavities that have had the administration of topical thrombin or microfibrillar hemostatic agents should not be autotransfused. Patients with renal or hepatic failure may not tolerate the increased levels of plasma-free hemoglobin or potassium that occurs with an autotransfusion. Relative contraindications include cesarean delivery and sickle cell disease.