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Oxygen carriers as alternatives to red cell transfusion

Joy L Fridey, MD
Section Editor
Arthur J Silvergleid, MD
Deputy Editor
Jennifer S Tirnauer, MD


The development of "artificial blood" or a "blood substitute" has been one of the great expectations of biotechnology and modern medicine. It is generally understood that no manufactured substance can perform the cellular and molecular functions of blood, but these terms remain popular with the media and the public. In the past decades, research efforts have been directed toward developing products that have one main purpose: to perform the oxygen-carrying and gas transport function of red blood cells. These products are referred to as oxygen carriers (OC) or oxygen therapeutics.

At the turn of the 21st century there was great optimism that rapidly advancing technology would lead to the development of OC that could be used in a variety of clinical settings. Many products were in phase III clinical trials, but this process was impeded by reports of side effects and regulatory concerns about safety. Development of some products was halted. There were allegations that some companies may have misled investors [1] or withheld outcome results [2]. Inability to obtain regulatory approval and sustain investor support resulted in the withdrawal of many products from clinical trials. In 2009, the remaining two companies ceased manufacture of their oxygen therapeutics and filed for bankruptcy. Currently, there are no clinical trials underway in the US for any products, and none is available on a compassionate-use basis.

In spite of these disappointing setbacks, there continues to be a pressing need for oxygen therapeutics, and it is unlikely that work in this field will cease altogether. Insights regarding the basic biology and physiology of hemoglobin and gas transport systems will lead to development of new products. It is also possible that modification of previously-tested carriers will result in new clinical trials. Because of ongoing medical and public interest in oxygen therapeutics, this topic review will provide general information about OC and will review clinical and historical highlights [3-5].

The use of red cells for transfusion and the issues related to oxygen delivery are discussed separately.

(See "Indications and hemoglobin thresholds for red blood cell transfusion in the adult".)


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Literature review current through: Sep 2016. | This topic last updated: Apr 15, 2014.
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