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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

  • C. Th. Smit Sibinga
  • P. C. Das
  • J. C. Fratantoni

Part of the Developments in Hematology and Immunology book series (DIHI, volume 33)

Table of contents

  1. Front Matter
    Pages I-XVI
  2. The Clinical Setting: How to Optimise Supportive Haemotherapy

    1. Front Matter
      Pages 1-1
    2. W. G. van Aken
      Pages 3-7
    3. W. G. Murphy
      Pages 9-15
    4. J. C. Fratantoni, C. Th. Smit Sibinga
      Pages 43-52
  3. Chemical and Biological Alternatives

    1. Front Matter
      Pages 53-53
    2. C. P. Schröder, W. T. A. van der Graaf, P. H. B. Willemse, E. Vellenga, L. de Leij, N. H. Mulder et al.
      Pages 81-95
    3. W. Helfrich, B. J. Kroesen, G. Molema, L. de Leij
      Pages 103-118
    4. C. R. Valeri, H. J. C. de Wit
      Pages 123-131
  4. Alternative Approaches in Clinical Practice

    1. Front Matter
      Pages 133-133
    2. P. L. Baele, B. Fraselle, J. M. Gouverneur, M. de Kock
      Pages 135-145
    3. E. Gluckman, V. Rocha, C. Chastang
      Pages 183-196
    4. L. T. Goodnough, H. J. C. de Wit
      Pages 197-205
  5. The Balance of Risks, Benefits and Costs

    1. Front Matter
      Pages 207-207
    2. C. R. Valeri, P. Crowley, J. Loscalzo
      Pages 209-214
    3. J. C. Fratantoni
      Pages 239-243
    4. J. C. Fratantoni, P. C. Das
      Pages 245-252
  6. Back Matter
    Pages 253-259

About this book

Introduction

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.

Keywords

blood care clinical trial critical care cytokine interferon plasma stem cells transfusion medicine transplantation

Editors and affiliations

  • C. Th. Smit Sibinga
    • 1
  • P. C. Das
    • 1
  • J. C. Fratantoni
    • 2
  1. 1.Red Cross Blood Bank Noord NederlandThe Netherlands
  2. 2.C.L. Mclntosh & Ass.RockvilleUSA

Bibliographic information