title: Alternatives to blood transfusion.
abstract: The use of alternatives to allogeneic blood continues to rest on the principles that blood transfusions have inherent risks, associated costs, and affect the blood inventory available for health-care delivery. Increasing evidence exists of a fall in the use of blood because of associated costs and adverse outcomes, and suggests that the challenge for the use of alternatives to blood components will similarly be driven by costs and patient outcomes. Additionally, the risk-benefit profiles of alternatives to blood transfusion such as autologous blood procurement, erythropoiesis-stimulating agents, and haemostatic agents are under investigation. Nevertheless, the inherent risks of blood, along with the continued rise in blood costs are likely to favour the continued development and use of alternatives to blood transfusion. We summarise the current roles of alternatives to blood in the management of medical and surgical anaemias.
authors.affiliation: Institute of Anaesthesiology, University and University Hospital Zurich, Zurich, Switzerland. donat.spahn@usz.ch
authors.forename: Donat R
authors.initials: DR
authors.lastname: Spahn
authors.forename: Lawrence T
authors.initials: LT
authors.lastname: Goodnough
mesh_terms: D000740:Anemia / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000517:prevention & control; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion / Q000191:economics / Q000379:methods*; D002908:Chronic Disease; D003365:Costs and Cost Analysis; D004920:Erythropoiesis / Q000502:physiology; D006397:Hematinics / Q000627:therapeutic use; D006470:Hemorrhage / Q000517:prevention & control; D006488:Hemostasis, Surgical / Q000379:methods; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D010347:Patient Care Planning; D019095:Point-of-Care Systems; D011300:Preoperative Care / Q000379:methods; D011364:Professional Practice / Q000592:standards; D019616:Thoracic Surgical Procedures / Q000379:methods; D065227:Transfusion Reaction; D014947:Wounds and Injuries / Q000601:surgery
chemical_list: D000933:Antifibrinolytic Agents; D006397:Hematinics; D006490:Hemostatics