Blood Substitutes

The many problems that beset the collection, production and use of donor-derived blood components have provided the impetus for the development of artificial blood substitutes. Several companies have tried to develop haemoglobin-based blood substitutes or chemical carriers of oxygen such as perfluorocarbons. Similarly, platelet membranes or particles coated with adhesive properties have been tried as substitutes for platelets. Unfortunately, all these products have proven to be clinically ineffective or, worse, to cause morbidity and mortality. It seems that the complex function of cells cannot easily be replicated. The drive is now on to develop more sophisticated products that mimic blood cell function or to grow blood cells in vitro from stem cells. However, it is likely that the development of these products will be lengthy and difficult and only serve niche indications. In the meantime, the 'virtual' blood substitutes that augment or stimulate the blood cell numbers and/or function are likely to expand in scope and clinical use. This edition first published 2013