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Updated: Jul 13, 2026

Induction of Alloantigen-specific Anergy in Human Peripheral Blood Mononuclear Cells by Alloantigen Stimulation with Co-stimulatory Signal Blockade

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Published on: March 14, 2011

Alternatives to allogeneic blood transfusions.

Andreas Pape¹, Oliver Habler

¹Clinic of Anoesthesiology, Intensive Care Medicine and Pain Management, J. W. Goethe University Hospital Frankfurt am Main, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany. a.pape@em.uni-frankfurt.de

Best Practice & Research. Clinical Anaesthesiology

|July 27, 2007

Summary

Exploring alternatives to allogeneic transfusions, this study evaluates autologous techniques like preoperative autologous blood donation (PAD) and acute normovolaemic haemodilution (ANH), alongside artificial oxygen carriers.

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Induction of Alloantigen-specific Anergy in Human Peripheral Blood Mononuclear Cells by Alloantigen Stimulation with Co-stimulatory Signal Blockade

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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

Area of Science:

Transfusion Medicine
Anesthesiology
Surgical Innovation

Background:

Allogeneic blood transfusions carry inherent risks and rising costs, necessitating safer, cost-effective alternatives.
Patient tolerance to acute normovolaemic anaemia defines transfusion policy limits.
Iatrogenic methods can enhance anaemia tolerance, preventing premature transfusions while ensuring tissue oxygenation.

Purpose of the Study:

To review and compare the efficacy and safety of various alternatives to allogeneic blood transfusions.
To assess the cost-effectiveness and risks associated with different autologous transfusion techniques.
To evaluate the potential of artificial oxygen carriers as substitutes for red blood cells.

Main Methods:

Review of autologous transfusion techniques: preoperative autologous blood donation (PAD), acute normovolaemic haemodilution (ANH), and intraoperative cell salvage (ICS).
Assessment of adjunctive therapies for PAD and ANH, including iron and erythropoietin.
Evaluation of artificial oxygen carriers: perfluorocarbon (PFC) and haemoglobin-based oxygen carriers (HBOCs).

Main Results:

ANH presents a low-risk, cost-effective method to reduce allogeneic transfusions.
PAD requires meticulous planning and carries a risk of mistransfusion; its cost-effectiveness is patient-specific.
Intraoperative cell salvage (ICS) can significantly decrease allogeneic blood use, though contraindications require clarification.
Artificial oxygen carriers (PFCs, HBOCs) show promise but lack current clinical approval due to insufficient safety and efficacy data.

Conclusions:

Autologous transfusion techniques, particularly ANH, offer viable alternatives to allogeneic blood.
Further research is essential to establish the safety and efficacy of artificial oxygen carriers for clinical application.
Optimizing transfusion strategies is crucial for improving patient outcomes and managing healthcare costs.