Ex-vivo red blood cells generation: a step ahead in transfusion medicine?

Blood transfusion and especially red blood cell (RBC) transfusion is an essential therapeutic act because it might be life-saving in several situations such as massive bleeding or as prolonged quality-of-life therapies in patients with chronic anemic disorders. Although the need for blood is thereby widespread, there is however a major imbalance between demand and supply of donors, so that there is a mounting research to develop suitable surrogates for human donated blood. Functional RBCs have already been generated from a variety of cellular progenitors (i.e., somatic stem cells, human embryonic stem cells and induced pluripotent stem cells) and synthetic biomaterials. Although these types of "artificial blood" carry several advantages over donated blood, including larger supply, lower risk of blood-borne pathogens transmission, no risk of immune incompatibility using group O, RhD-negative RBCs, and extended survival of stored RBCs, their efficacy has not been extensively tested thus far in clinical trials. Therefore, while it seems premature at this point in time to conclude that ex-vivo manufacturing of blood might be the definitive solution to the current shortage of blood supply, it represents however a valuable starting point for translational research in transfusion medicine.