Treatments of a majority of hematological diseases today rely on transfusion of blood as the ultimate resort. Efforts for developing viable blood substitutes revolve around the capability of RBCs to carry oxygen to different parts of the body. Thus, most of the products that are in advanced stage of development are the derivatives of ‘hemoglobin-based oxygen carriers’, or simply HBOCs.
Owing to a surge in elective surgical methods and the threat of transmission of blood-borne microorganisms, like HIV, have triggered the need for the development synthetic replacement of human blood. These substitutes are strictly developed to provide substitute for red blood cells.
As no blood substitute has yet received a nod from USFDA, a lot of work is required to be carried out in this domain. Let’s have a deeper insight into the notion of blood substitutes, along with some of its pros and cons.
Features Of An Ideal Blood Substitute
The prime unfavorable effects of blood transfusion link to the ability of blood to transmit infections and antigenicity of the donor. Hence, an ideal blood substitute is one that diminishes the capability to transmit infectious pathogens, and lacks antigenicity.
Moreover, it should be easily available, must have longer half life, and should have the capability to be stored at room temperature. It should be capable to deliver apt amount of oxygen, as compared to normal RBCs of human blood.
Potential Benefits Of Blood Substitutes
If such blood substitutes were in fact developed, it would presumably play a pivotal role for various elective surgeries and in establishing trauma care. It would also be beneficial for those patients who are in requirement of frequent blood transfusions, such as patients with aplastic anemia and myelodysplastic syndrome.
In addition these substitutes would presumably be used as preservatives for organs that would check the reperfusion damage to donor organs. Religious groups with apprehension over the products derived from human blood may also accept these synthetic substitutes.
Adverse Impacts Of Blood Substitutes
Everything in this world has its own pros and cons, and blood substitutes are no exception to it. Hemoglobin based blood substitutes have their own set of side effects. Some of the common potential side effects that could be linked with blood substitutes include gastrointestinal disturbances, hypertension, fever, stroke, hemoglobinuria, oliguria, jaundice, rashes, diarrhea, and rise in lipase levels, etc. Though most of these side effects were found to be temporary, clinical trials including these synthetic agents were withdrawn due to these potential side effects.
In spite years of research, the most suitable blood substitute still seems to be far-fetched. A majority of attempts in the beginning were failed due to the adverse effects associated with them. However, persistent research facilitated us to understand the physiology of RBCs and interaction of these cells with their surroundings. This has immensely assisted in developing advanced products that don’t show substantial vasoactive properties.
With the advancement in effective blood substitutes, it is believed that the requirement of blood transfusion in trauma settings will be phased out. Large-scale production of these blood substitutes would also help to address the anticipated requirement for blood, with the pool of blood donors is diminishing rapidly