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Transfusion Dec 2014The refusal of allogeneic human blood and blood products by Jehovah's Witness (JW) patients complicates the treatment of life-threatening anemia. For JW patients, when...
The refusal of allogeneic human blood and blood products by Jehovah's Witness (JW) patients complicates the treatment of life-threatening anemia. For JW patients, when hemoglobin (Hb) levels decrease beyond traditional transfusion thresholds (<7 g/dL), alternative methods to allogeneic blood transfusion can be utilized to augment erythropoiesis and restore endogenous Hb levels. The use of erythropoietin-stimulating agents and intravenous iron has been shown to restore red blood cell and Hb levels in JW patients, although these effects may be significantly delayed. When JW patients have evidence of life-threatening anemia (Hb <5 g/dL), oxygen-carrying capacity can be supplemented with the administration of Hb-based oxygen carriers (HBOCs). Although HBOCs are not Food and Drug Administration (FDA) approved, they may be obtained and administered with FDA, institutional review board, and patient approval. We describe a protocol-based algorithm to the management of life-threatening anemia in JW patients and review time to anemia reversal and patient outcomes using this approach.
Topics: Administration, Intravenous; Algorithms; Anemia; Blood Substitutes; Erythropoiesis; Hematinics; Hemoglobins; Humans; Iron; Jehovah's Witnesses; Patient Participation
PubMed: 25330835
DOI: 10.1111/trf.12888 -
Cardiovascular & Hematological Agents... 2019Artificial blood is an innovative concept of transfusion medicine where specifically designed compounds perform the task of transport and delivery of oxygen in the body...
Artificial blood is an innovative concept of transfusion medicine where specifically designed compounds perform the task of transport and delivery of oxygen in the body to replace this function of allogenic human blood transfusion. Several molecules have been developed in the past few decades to achieve this objective and continous refinements are being continuously made in the quest of the ideal blood substitute. Currently, available technology manufactures artificial blood from haemoglobin obtained from outdated human/bovine blood (Haemoglobin Based Oxygen Carriers) or utilizing Perfluorocarbons. These synthetic blood substitutes are advantageous in that they do not require compatibility testing, are free from blood borne infections, have prolonged shelf life and do not require refrigeration. Artificial blood is projected to have a significant impact on the development of medical care in the future. It can complement the current blood products for transfusion and create a stable supply of safe and effective products. It is likely to reduce the requirements of blood transfusions drastically especially in settings of trauma and surgery thereby reducing the reliance on banked donated blood.
Topics: Anemia; Animals; Blood Substitutes; Blood Transfusion; Fluorocarbons; Hemoglobins; Humans; Resuscitation
PubMed: 31204626
DOI: 10.2174/1871525717666190617120045 -
Optics Express Aug 2022We demonstrate a short-wave infrared computed tomography method. It uses a fiber-coupled 1.44µm super-luminescent diode as light source, a PbSe photodiode as infrared...
We demonstrate a short-wave infrared computed tomography method. It uses a fiber-coupled 1.44µm super-luminescent diode as light source, a PbSe photodiode as infrared detector, and an electronically controlled rotation and translation stage for high-speed Radon scanning. It is a safe and low power nondestructive testing method that can be used for the detection of plastic polymers, biological tissue and other materials that visible light cannot penetrate. We analyze the theoretical resolution of the method and build a short-wave infrared computed tomography system, which realizes the tomography and 3D reconstruction of black plastic bottles and artificial blood vessels. The measured resolution reaches10µm.
Topics: Blood Substitutes; Plastics; Radon; Tomography, X-Ray Computed
PubMed: 36242274
DOI: 10.1364/OE.467437 -
Journal of Internal Medicine Mar 2008Alternatives to donor blood have been developed in part to meet increasing demand. However, new biotechnologies are often associated with increased perceptions of risk... (Review)
Review
Alternatives to donor blood have been developed in part to meet increasing demand. However, new biotechnologies are often associated with increased perceptions of risk and low acceptance. This paper reviews developments of alternatives and presents data, from a field-based experiment in the UK and Holland, on the risks and acceptance of donor blood and alternatives (chemical, genetically modified and bovine). UK groups perceived all substitutes as riskier than the Dutch. There is a negative association between perceived risk and acceptability. Solutions to increasing acceptance are discussed in terms of implicit attitudes, product naming and emotional responses.
Topics: Blood Donors; Blood Substitutes; Blood Transfusion; Cohort Studies; Health Care Surveys; Health Knowledge, Attitudes, Practice; Humans; Netherlands; Patient Acceptance of Health Care; Risk Assessment; Transfusion Reaction; United Kingdom
PubMed: 18205767
DOI: 10.1111/j.1365-2796.2007.01897.x -
Annals of the Royal College of Surgeons... Mar 1976With the development of modern methods of surgery, anaesthesia, and pre- and postoperative care the requirement for blood substitutes is continuously increasing. We... (Comparative Study)
Comparative Study
With the development of modern methods of surgery, anaesthesia, and pre- and postoperative care the requirement for blood substitutes is continuously increasing. We present a review of the different blood substitutes which are already in clinical use or in an advanced stage of experimental investigation for possible practical administration. Our own clinical experience with dextrans and experimental studies on stroma-free haemoglobin and hydroxyethyl starch solutions are described.
Topics: Animals; Blood Circulation; Blood Volume; Dextrans; Electrolytes; Emulsions; Erythrocytes; Fluorocarbons; Gelatin; Hemoglobins; Humans; Hydroxyethyl Starch Derivatives; Plasma Substitutes; Povidone
PubMed: 57736
DOI: No ID Found -
Trends in Biotechnology Apr 2014Persistent safety concerns have stalled the development of viable hemoglobin (Hb)-based oxygen carriers (HBOCs). HBOCs have several advantages over human blood,... (Review)
Review
Persistent safety concerns have stalled the development of viable hemoglobin (Hb)-based oxygen carriers (HBOCs). HBOCs have several advantages over human blood, including availability, long-term storage, and lack of infectious risk. The basis of HBOC toxicity is poorly understood, however, several mechanisms have been suggested, including Hb extravasation across the blood vessel wall, scavenging of endothelial nitric oxide (NO), oversupply of oxygen, and heme-mediated oxidative side reactions. Although there are some in vitro and limited animal studies supporting these mechanisms, heme-mediated reactivity appears to provide an alternative path that can explain some of the observed pathophysiological changes. Moreover, recent mechanistic and animal studies support a role for globin and heme scavengers in controlling oxidative toxicity associated with Hb infusion.
Topics: Animals; Biotechnology; Blood Substitutes; Heme; Hemoglobins; Humans; Models, Molecular; Oxidative Stress
PubMed: 24630491
DOI: 10.1016/j.tibtech.2014.02.006 -
Biomolecules Jan 2017Intense efforts have been made by both industry and academia over the last three decades to produce viable hemoglobin (Hb)-based oxygen carriers (HBOCs), also known as... (Review)
Review
Intense efforts have been made by both industry and academia over the last three decades to produce viable hemoglobin (Hb)-based oxygen carriers (HBOCs), also known as "blood substitutes". Human trials conducted so far by several manufactures in a variety of clinical indications, including trauma, and elective surgeries have failed and no product has gained the Food and Drug Administration approval for human use. Safety concerns due to frequent incidences of hemodynamic, cardiac events, and even death led to the termination of some of these trials. Several second generation HBOC products that have been chemically and/or genetically modified (or in some cases ligated with carbon monoxide (CO)) found a new clinical application in conditions as complex as sickle cell disease (SCD). By virtue of higher oxygen affinity (P) (R-state), and smaller size, HBOCs may be able to reach the microvasculature unload of oxygen to reverse the cycles of sickling/unsickling of the deoxy-sickle cell Hb (HbS) (T-state), thus preventing vaso-occlusion, a central event in SCD pathophysiology. However, biochemically, it is thought that outside the red blood cell (due to frequent hemolysis), free HbS or infused HBOCs are capable of interfering with a number of oxidative and signaling pathways and may, thus, negate any benefit that HBOCs may provide. This review discusses the advantages and disadvantages of using HBOCs in SCD.
Topics: Anemia, Sickle Cell; Blood Substitutes; Clinical Trials as Topic; Drug Approval; Humans; Oxidative Stress; Signal Transduction
PubMed: 28054978
DOI: 10.3390/biom7010002 -
ASAIO Journal (American Society For... 2013The development of oxygen (O2)-carrying blood substitutes has evolved from the goal of replicating blood O2 transport properties to that of preserving microvascular and... (Review)
Review
The development of oxygen (O2)-carrying blood substitutes has evolved from the goal of replicating blood O2 transport properties to that of preserving microvascular and organ function, reducing the inherent or potential toxicity of the material used to carry O2, and treating pathologies initiated by anemia and hypoxia. Furthermore, the emphasis has shifted from blood replacement fluid to "O2 therapeutics" that restore tissue oxygenation to specific tissues regions. This review covers the different alternatives, potential and limitations of hemoglobin-based O2 carriers (HBOCs) and perfluorocarbon-based O2 carriers (PFCOCs), with emphasis on the physiologic conditions disturbed in the situation that they will be used. It describes how concepts learned from plasma expanders without O2-carrying capacity can be applied to maintain O2 delivery and summarizes the microvascular responses due to HBOCs and PFCOCs. This review also presents alternative applications of HBOCs and PFCOCs namely: 1) How HBOC O2 affinity can be engineered to target O2 delivery to hypoxic tissues; and 2) How the high gas solubility of PFCOCs provides new opportunities for carrying, dissolving, and delivering gases with biological activity. It is concluded that the development of current blood substitutes has amplified their applications horizon by devising therapeutic functions for O2 carriers requiring limited O2 delivery capacity restoration. Conversely, full, blood-like O2-carrying capacity reestablishment awaits the control of O2 carrier toxicity.
Topics: Animals; Blood Substitutes; Gases; Humans; Oxygen; Solubility
PubMed: 23820271
DOI: 10.1097/MAT.0b013e318291fbaa -
Pflugers Archiv : European Journal of... Feb 2021Developing biocompatible, synthetic oxygen carriers is a consistently challenging task that researchers have been pursuing for decades. Perfluorocarbons (PFC) are... (Review)
Review
Developing biocompatible, synthetic oxygen carriers is a consistently challenging task that researchers have been pursuing for decades. Perfluorocarbons (PFC) are fascinating compounds with a huge capacity to dissolve gases, where the respiratory gases are of special interest for current investigations. Although largely chemically and biologically inert, pure PFCs are not suitable for injection into the vascular system. Extensive research created stable PFC nano-emulsions that avoid (i) fast clearance from the blood and (ii) long organ retention time, which leads to undesired transient side effects. PFC-based oxygen carriers (PFOCs) show a variety of application fields, which are worthwhile to investigate. To understand the difficulties that challenge researchers in creating formulations for clinical applications, this review provides the physical background of PFCs' properties and then illuminates the reasons for instabilities of PFC emulsions. By linking the unique properties of PFCs and PFOCs to physiology, it elaborates on the response, processing and dysregulation, which the body experiences through intravascular PFOCs. Thereby the reader will receive a scientific and easily comprehensible overview why PFOCs are precious tools for so many diverse application areas from cancer therapeutics to blood substitutes up to organ preservation and diving disease.
Topics: Animals; Blood Substitutes; Drug Compounding; Emulsions; Fluorocarbons; Humans; Oxygen
PubMed: 33141239
DOI: 10.1007/s00424-020-02482-2 -
Bosnian Journal of Basic Medical... Sep 2022The blood-brain barrier (BBB) functions as a highly selective border of endothelial cells, protecting the central nervous system from potentially harmful substances by... (Review)
Review
The blood-brain barrier (BBB) functions as a highly selective border of endothelial cells, protecting the central nervous system from potentially harmful substances by selectively controlling the entry of cells and molecules, including components of the immune system. To study the BBB properties, find suitable therapies, and identify new drug targets, there is a need to develop representative in vitro BBB models. In this article, we describe the astrocyte roles in the BBB functioning and human in vitro BBB models.
Topics: Astrocytes; Blood Substitutes; Blood-Brain Barrier; Endothelial Cells; Humans
PubMed: 35366791
DOI: 10.17305/bjbms.2021.6943