Davey Richard J
New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.
Curr Hematol Rep. 2004 Mar;3(2):92-6.
Blood shortages are increasingly common as the donor base declines and extensive restrictions on blood donation disqualify many donors. Red blood cell (RBC) and platelet substitutes have long been anticipated as alternatives to standard transfusions. However, difficulties in manufacturing, efficacy, and safety have slowed the development of these products. New understanding of the relationship between blood viscosity, oxygen transport, and vasoactivity have led to more effective RBC substitutes, several of which are in advanced clinical trials. In addition, creative approaches to RBC membrane modification, such as the enzymatic cleavage of ABH glycoproteins, may lead to a universal RBC. Advances in the understanding of platelet membrane behavior at low temperatures may lead to extended platelet storage at refrigerator temperatures. Standard transfusions of human RBCs and platelets will not be replaced soon. However, these new products will be a useful alternative for selected clinical applications and will lessen our dependence on our marginally adequate blood supply.
随着献血者群体减少以及对献血的广泛限制使许多献血者失去资格，血液短缺日益普遍。长期以来，人们一直期待红细胞（RBC）和血小板替代品能成为标准输血的替代方案。然而，制造、疗效和安全性方面的困难减缓了这些产品的开发进程。对血液粘度、氧气运输和血管活性之间关系的新认识催生了更有效的红细胞替代品，其中几种正处于晚期临床试验阶段。此外，对红细胞膜进行修饰的创新方法，如酶切ABH糖蛋白，可能会产生通用的红细胞。对血小板膜在低温下行为的认识进展可能会使血小板在冷藏温度下延长保存期限。人类红细胞和血小板的标准输血方式不会很快被取代。然而，这些新产品将成为特定临床应用的有用替代方案，并将减少我们对勉强足够的血液供应的依赖。
