Alternative Approaches to Human Blood Resources in Clinical Practice: Proceedings of the Twenty-Second International Symposium on Blood Transfusion, Groningen 1997, organized by the Red Cross Blood Bank Noord Nederland
Cees Smit Sibinga, P.C. Das, J.C. Fratantoni
Springer Science & Business Media, Sep 30, 1998 - Medical - 260 pages
Currently blood is a volatile issue. The safety of blood and the quantification of transfusion risks have been dominant themes that have stimulated the development of alternative approaches in this rapidly developing area. In clinical medicine conventional blood and its components are used in supportive therapies dependent on the choice of apparent uncritical trigger factors. A compounding factor is depth of prospective clinical trials for evidence. Such trials in critical care areas would be of enormous value, not only in recording adverse effects and under-transfusion, but also indicating the value of decision analysis and cost-effectiveness in transfusion practice. Alternative approaches include the use of cytokines, growth factors, humanised monoclonal antibodies, recombinant plasma factors, and buffy coat derived natural human interferons. These are being increasingly implemented in the clinic. Solutions for oxygen transport are being developed and fibrinogen coated microcapsules are being investigated for thrombocytopenia. In surgical patients, various crystalloid and colloid combinations are explored as volume replacements. To avoid allogeneic transfusions, beneficial blood saving methods include various strategies, such as autologous deposits, normovolemic haemodilution and various agents including aprotinin, tranecamic acid, desmopressin and erythropoietin, but their use in hospital shows considerable variations. That umbilical cord blood could be a significant source of allogeneic stem cells in related and unrelated transplantation is illustrated by the increasing number of cord blood banks in Europe and elsewhere. Future blood resources are likely to face several challenges: immediate challenges relate to increased regulatory and political oversights; intermediate solutions would offer some improvements in public health and alleviate public fear but probably not address the economic challenges thrust upon the medical care system.
As we approach the year 2000, the major concerns about transfusion medicine remain its logistics, safety and effectiveness. This theme is presented in the proceedings of the 22nd International Symposium on Blood Transfusion, developed in 21 up-to-date topics, collected and discussed in four sections.
This book will be of timely value to students, professionals and all others interested or involved in the field of transfusion medicine, whether clinical or related.
What people are saying - Write a review
We haven't found any reviews in the usual places.
What Should Trigger a Transfusion?
EvidenceBased Transfusion Medicine or the Need to Evaluate Clinical
The Role of O Transport in the Development of the Transfusion Trigger
Recombinant Human Erythropoietin Could It Be Used in a Better Way?
The Development of Synthocytes a Novel Platelet Substitute
Natural Human Interferon
Alternative Approaches in Anaesthesiology
Other editions - View all
albumin allogeneic blood transfusion anaemia Anesth antigen aprotinin autologous blood donation bispecific antibody bleeding blood cell transfusion blood donation blood loss blood products blood transfusion blood volume breast cancer BsAb bypass cardiac output cardiac surgery chemotherapy Clin clinical trials cord blood bank cord blood transplantation coronary critically ill patients decreased desmopressin detection diabody disease dose effect efficacy EGP2 Engl engraftment erythropoietin evaluated evidence factors g/dl GM-CSF Goodnough LT graft GvHD haematocrit haematopoietic stem cells haemoglobin haemoglobin concentration hospitals increased infection interferon interventions Lancet Laupacis molecules mortality odds ratio orthopaedic outcome oxygen delivery patients receiving patients undergoing perioperative peripheral blood platelet postoperative potential predonation randomised randomized recipients recombinant human erythropoietin red blood cell red cell transfusion reduce risk scFv surgical patients Synthocytes techniques tion tissue tranexamic acid transfusion medicine transfusion practice transfusion trigger treatment tumour cells umbilical cord blood units vascular viral