Alternatives to Blood Transfusions
In some cases, options other than blood product transfusions may be used.
When a patient has lost a lot of fluids, the body can go into a type of shock. This may be treated or prevented by giving solutions to expand fluid volume in order to keep blood circulating through vital organs. The solutions are put right into the bloodstream through a vein. They boost fluid volume and help with circulation, but don’t carry oxygen or raise the number of blood cells.
The body naturally makes hormone-like substances called hematopoietic (HE-muh-toe-poy-ET-ick) growth factors that cause the bone marrow to make more blood cells. Man-made versions of some of these growth factors are available to help people with low blood cell counts. Growth factors can be used to boost red blood cell, white blood cell, or platelet counts.
Growth factors may help patients who would otherwise need transfusions. But they have some drawbacks that may limit their use in some cases:
- Unlike transfusions, growth factors often take many days or weeks to raise blood counts, so they may not be useful in people who need their blood cell levels raised quickly, such as those who are actively bleeding.
- People who have severe bone marrow disease may not respond to the growth factors because they don’t have enough blood-producing cells in their bone marrow.
- Some growth factors might cause certain types of cancer cells (such as lymphocytic leukemia, multiple myeloma, head and neck cancer, breast cancer, cervical cancer, and some kinds of lung cancer cells) to grow more quickly.
- Growth factors generally cost a lot more than transfusions.
Because of these drawbacks, certain growth factors are not used in people whose treatment is expected to cure their cancer. And when they are used, they are given for as short a time as possible.
Intra-operative or post-operative blood salvage
Patients getting surgery sometimes need transfusions to replace blood lost during or after the operation. Sometimes this lost blood can be “salvaged” or saved by collecting it with a special machine and giving it back into the patient.
Giving a person back his or her own blood is called an autologous (aw-TAHL-uh-gus) transfusion. It cuts down on the need for transfusions from other donors. But some studies have found tumor cells in blood salvaged during cancer operations, and this isn’t something that can be done for all patients. (Another type of autologous transfusion is described in Donating Blood.)
So far, there is no real substitute for human blood. But researchers are working to develop a liquid that can carry oxygen and replace blood, at least for a short time, in certain situations.
Some products being tested can do some of the work of red blood cells, such as carrying oxygen to tissues, but cannot replace the many functions of human blood.
Chang TM. From artificial red blood cells, oxygen carriers, and oxygen therapeutics to artificial cells, nanomedicine, and beyond. Artif Cells Bld Substit Immobil Biotechnol. 2012;40(3):197-99.
Cushing MM, Ness PM. Principles of red blood cell transfusion. In: Hoffman R, Benz EJ, Shattil SJ, Furie B, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2009:2209-2218.
Ghinea R, Greenberg R, White I, Sacham-Shmueli E, Mahagna H, Avital S. Perioperative blood transfusion in cancer patients undergoing laparoscopic colorectal resection: risk factors and impact on survival. Tech Coloproctol. 2013 Oct;17(5):549-554.
Hay SN, Scanga L, Brecher ME. Life, death, and the risk of transfusion: a university hospital experience. Transfusion. 2006;46(9):1491-1493.
Henkel-Honke T, Oleck M. Artificial oxygen carriers: a current review. AANA J. 2007;75:205-211.
Vandegriff KD, Winslow RM. Hemospan: design principles for a new class of oxygen therapeutic. Artif Organs. 2009;33(2):133-138.
Last Medical Review: 06/20/2016
Last Revised: 06/20/2016