Abstract
To begin, it should be clarified that the term “artificial blood” is really a misnomer. The complexity of blood is far too great to allow for absolute duplication in a laboratory. Instead, researchers have focused their efforts on creating artificial substitutes for 2 important functions of blood: oxygen transport by red blood cells and hemostasis by platelets. A number of driving forces have led to the development of artificial blood substitutes (1). One major force is the military, which requires a large volume of blood products that can be easily stored and readily shipped to the site of casualties. Another force is HIV; with the advent of this virus, the medical community and the public suddenly became aware of the significance of transfusion-transmitted diseases and became concerned about the safety of the national blood supply. A third force is the growing shortage of blood donors. Approximately 60% of the population is eligible to donate blood, but fewer than 5% are regular blood donors (2). A unit of blood is transfused every 3 seconds in the USA, and the number of units transfused each year has been increasing at twice the rate of donor collection. Artificial blood products offer many important benefits (3). First, they are readily available and have a long shelf life, allowing them to be stocked in emergency rooms and ambulances and easily shipped to areas of need. Second, they can undergo filtration and pasteurization processes to virtually eliminate microbial contamination. No product can claim to be 100% risk-free for infectious agents, but these substitutes have a greatly increased level of safety. Third, they do not require blood typing, so they can be infused immediately and for all patient blood types. Fourth, they do not appear to cause immunosuppression in the recipient. In the sections that follow, the different types of red cell and platelet substitutes currently under development will be briefly reviewed.
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