BACKGROUND: To reduce the amount of homologous transfusion with its inherent problems of transmission of viral hepatitis, acquired immune deficiency syndrome and others, many institutions use comprehensive blood conservation methods (CBCM) in open heart and major aortic operations. The purpose of this study is to compare the amount and cost of homologous transfusion and the efficacy of coagulation between patients with or without CBCM adoption. METHODS: We prospectively assessed available CBCM of our institution in 20 patients, comparing the requirements of blood products, their cost and the efficacy of blood coagulation with those of another 20 patients similar in age, types of operation, operation difficulty and duration of bypass time retrospectively. RESULT: Fewer whole blood and platelet concentrates were transfused in patients with CBCM (p<0.05). There are no significant differences in the amount of used packed red blood cell and fresh frozen plasma between two groups. Partial thromboplastin time is significantly short in patient with CBCM (p<0.05). The prevalence of complications and mean extra-financial cost for using cellsaver, platelete pheresis and homologous blood products are low in patients with CBCM. CONCLUSIONS: The CBCM requires additional cost won but CBCM reduces the requirements of homologous blood effectively.