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The Ideal Blood Substitute: Probably Not in Our Lifetimes

The Ideal Blood Substitute: Probably Not in Our Lifetimes

BETHESDA, Maryland—The search for the ideal blood substitute continues,
although with less urgency now that the nation’s blood supply is safer
than it has ever been. None of the products currently being developed and
nearing licensure can truly be considered substitutes for blood, according
to Harvey Klein, MD.

Some of these products may, however, "have a niche use, particularly
during surgery, where the endpoint will be to decrease or eliminate the use
of allogeneic blood, but they are not going to replace either transfusion or
recombinant human erythropoietin for a cancer patient during
chemotherapy," he said.

"Nothing is going to replace blood, red blood cells, or
erythropoietin in the near future."

Dr. Klein is chief, Transfusion Medicine, at the National Institutes of
Health, in Bethesda, Maryland,
and professor of medicine and pathology at the Johns Hopkins School of
Medicine in Baltimore.

Safe Enough?

The risk of HIV infection through blood is one in every two million units
of transfused blood. "The risk of hepatitis infection is also very
low," Dr. Klein said, "probably less common than 1 in 180,000
units for hepatitis B, and now with direct assays for the virus, around 1
for every two million units transfused for hepatitis C."

"Blood is safer than it’s ever been before, but there remain a
substantial number of complications," Dr. Klein noted. "One in
every 12,000 units of blood in the United States is given to the wrong
patient. I find that an astonishing statistic."

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