Blood Substitutes

There are efforts to create a blood substitute have lasted over 70 years mainly targeting red blood cells oxygen transport.

Many advanced-phase clinical trial products are hemoglobin derivatives called oxygen carriers.

The rise in elective surgeries and the ongoing risk of blood-borne pathogens have prompted efforts to create a synthetic substitute for human red blood cells.

The oxyhemoglobin dissociation curve is sigmoid-shaped due to cooperative effects of hemoglobin’s oxygen binding sites.

Hemoglobin’s oxygen binding is influenced due to temperature and blood pH.

Stroma-free hemoglobin solutions offer advantages over red blood cells including sterilization resistance and a two-year room temperature shelf life.

Acellular hemoglobin solutions are less effective at oxygenation than packed red blood cells. Red blood cells release oxygen at a hemoglobin p-50 of about 26.5 mm Hg.

Blood transfusion risks stem from donor antigenicity and infection transmission. An ideal blood substitute should deliver oxygen comparably to normal human red blood cells

Trauma and emergency situations

Perioperative use

Patients with rare blood types

Chronic conditions

High-risk infections

A developed blood substitute would significantly enhance trauma care, elective surgeries, and support patients requiring long-term blood transfusions due to medical conditions.

Products may preserve organs and reduce reperfusion injury in donors.

Religious and ethnic groups concerned about human-derived blood products might accept them to enhance patient care.

Severe hemorrhagic shock

Inability to address coagulation deficits

Renal failure or kidney dysfunction

Hyperoxia

Uncontrolled Infection or Sepsis

Severe cardiovascular diseases