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Alternatives and adjuncts to blood transfusion 6.


  • 1. Introduction?
  • 6: Alternatives and adjuncts to blood transfusion.
  • Description.

Alternatives and adjuncts to blood transfusion Essentials Transfusion alternatives were mostly developed to reduce blood use in surgery but have much wider application. They are most effective when used in combination and as part of a comprehensive patient blood management programme. Predeposit autologous blood donation before surgery is of uncertain benefit and now has very restricted indications in the UK. Intraoperative cell salvage ICS is effective and may be life-saving in elective or emergency high blood loss surgery and management of major haemorrhage. Postoperative cell salvage PCS and reinfusion can reduce blood use in joint replacement and scoliosis surgery.

Tranexamic acid antifibrinolytic is inexpensive, safe and reduces mortality in traumatic haemorrhage.

It reduces bleeding and transfusion in many surgical procedures and may be effective in obstetric and gastrointestinal haemorrhage. Erythropoiesis stimulating agents ESAs , such as erythropoietin, are standard therapy in renal anaemia and can support blood conservation in some cancer chemotherapy patients and autologous blood donation programmes. They may also be effective in selected patients with myelodysplasia.

ESAs may cause hypertension and thromboembolic problems. Safe parenteral iron preparations are now available and may produce more rapid and complete responses in iron deficiency anaemia. Indications include intolerance of oral iron, support for ESA therapy and as an alternative to transfusion in perioperative and postpartum anaemia. Effective transfusion in surgery and critical care. Management of patients who do not accept transfusion. Patients getting surgery sometimes need transfusions to replace blood lost during or after the operation.

Giving a person back his or her own blood is called an autologous transfusion.

It cuts down on the need for transfusions from other donors. Another type of autologous transfusion is described in Donating Blood. So far, there is no real substitute for human blood.

Alternative Blood Products and Clinical Needs in Transfusion Medicine

But researchers are working to develop a liquid that can carry oxygen and replace blood, at least for a short time, in certain situations. Some products being tested can do some of the work of red blood cells, such as carrying oxygen to tissues, but cannot replace the many other functions of human blood.

The American Cancer Society medical and editorial content team Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing. From artificial red blood cells, oxygen carriers, and oxygen therapeutics to artificial cells, nanomedicine, and beyond.

Principles of red blood cell transfusion. Basic Principles and Practice. Perioperative blood transfusion in cancer patients undergoing laparoscopic colorectal resection: Many complex issues related to scale-up production and the potential immunogenicity neoantigen formation of products produced in vitro remain to be resolved. However, the development of these products will inform and transform quality control and manufacturing processes for traditional blood products.

National Center for Biotechnology Information , U. Journal List Stem Cells Int v. Published online Apr 8. Received Nov 9; Accepted Dec This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Transfusion Alternatives in Transfusion Medicine - Index

This article has been cited by other articles in PMC. Abstract The primary focus of national blood programs is the provision of a safe and adequate blood supply. Introduction In the last 30 years, transfusion medicine has evolved from a field focused on blood component therapy and red blood cell serology to include advanced cellular therapies produced by ex vivo expansion [ 1 , 2 ]. Open in a separate window. Materials and Methods The authors conducted searches on PubMed and Google using the following search terms: Perspective on Needs in Transfusion Medicine Since the beginning of modern transfusion therapy extraordinary efforts have been required to maintain a safe and adequate blood supply [ 23 — 25 ].

The Blood Supply In developed nations the blood supply is adequate overall [ 60 — 62 ], but extreme weather conditions and natural disasters such as the recent earthquake and tsunami in Japan and flooding in the United States disrupt routine blood collection activities leading to temporary shortages. Prevention of Transfusion-Transmitted Infections: Alloimmunization As the scientific basis for producing better and safer products for transfusion through donor screening and product testing has made transfusion safer, alloimmunization resulting from transfusion has emerged as a major issue in clinical care.

Impact of Ex Vivo Generated Blood Cells on Needs in Transfusion Medicine Red blood cells have been successfully generated ex vivo from peripheral blood mononuclear cells, cord blood, and human-induced pluripotent stem cell hiPSC and human embryonic stem cell hESC lines. Component therapy to cellular therapy and beyond—a Darwinian approach to transfusion medicine. Mason C, Manzotti E. Regenerative medicine cell therapies: Roddie C, Peggs KS. Donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation.

Expert Opinion on Biological Therapy. Adoptive T cell therapy of cancer. Current Opinion in Immunology. Sipuleucel-T APC for prostate cancer. Expert Review of Anticancer Therapy. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. The New England Journal of Medicine. Notch-mediated expansion of human cord blood progenitor cells capable of rapid myeloid reconstitution. Infusion of ex vivo expanded T regulatory cells in adults transplanted with umbilical cord blood: Stem cells—a source of adult red blood cells for transfusion purposes: Erythroid cells in vitro: Current Opinion in Hematology.

Humanized culture medium for clinical expansion of human erythroblasts. Ex vivo generation of fully mature human red blood cells from hematopoietic stem cells. Red blood cell generation from human induced pluripotent stem cells: Direct conversion of human fibroblasts to multilineage blood progenitors.

Growth factors

Proof of principle for transfusion of in vitro-generated red blood cells. Infusion of mature megakaryocytes into mice yields functional platelets. Journal of Clinical Investigation. Covalently immobilized glycosaminoglycans enhance megakaryocyte progenitor expansion and platelet release. Safety and effectiveness of granulocyte transfusions in resolving infection in people with neutropenia The RING Study http: October 8, , http: History of blood transfusion.

Universal access to safe blood. Role of regulatory agencies. Global collaboration for blood safety. Millennium Development Goals Reports — Millenium Development Goal 8. ISBT Board authorizes formation of new working party. Alternative strategies in assuring blood safety: Globalisation and blood safety.


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Progress in monitoring blood safety. Bacterial contamination of platelets. Transfusion and Apheresis Science. Screening of single-donor apheresis platelets for bacterial contamination: Applied Blood Group Serology. Montgomery Scientific Publications; Blackwell Scientific Publications; Red cell genotyping and the future of pretransfusion testing.

Prevention and diagnosis of delayed haemolytic transfusion reactions. Fatalities reported to FDA following blood collection and transfusion. Annual summary for fiscal year The Biovigilance Task Group. Biovigilance in the United States: Efforts to bridge a critical gap in patient safety and donor health.


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    Volume expanders

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