الفهرس 
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Abstract
This prospective randomized open clinical trial was performed on geriatric patients subjected to radical cystectomy and bladder substitution. Eligible patients were randomly allocated to one of two equal study groups subjected to the same anaesthetic management, the acute normovolaemic haemodilution (ANH) group, and the control(C) group. In the ANH group two units of blood were withdrawn from the patient after lumbar epidural analgesia and before induction of general anaesthesia. Three liters of Ringer’s solution were administrated to replace the withdrown blood. The two withdrwan unites were reinfused at the end of the bladder dissection and surgical haemostasis. In the control group, routine transfusion practice was used. All patients were monitored by continuous 5-¬leads electrocardiography, pulse oximetry, capnography, core body temperature, central venous pressure, and invasive arterial pressure. Standard coagulation tests, (prothrombin concentration, activated partial thromboplastin time, fibrinogen level, and platelet count) and Immune response parameters including interleukin-¬2 and interleukin-¬4 were recorded basally, first, third, fifth, and at the seventh postoperative days. In conclusion, acute normovolaemic haemodilution in elderly patients subjected to radical cystectomy was a safe technique as it provided haemodynamic stabilty without significant alteration in coagulation mechanism. The use of homologous blood compared to autologous blood for transfusion does not produce significant deleterious immunomodulatory effect.