Alternatives to Regular Blood Transfusions

By Farley, Dixie | FDA Consumer, July-August 1994 | Go to article overview

Alternatives to Regular Blood Transfusions


Farley, Dixie, FDA Consumer


The second genetically engineered blood clotting factor and a new drug to stem bleeding in heart surgery last year joined other alternatives to regular "homologous" blood transfusion - blood transfused into someone other than the donor.

New steps by the Food and Drug Administration are helping to make the public blood supply as safe as possible. (See "The Real Scoop on AIDS and Shortages.") Alternatives, too, may increase safety for some patients, including those with the clotting disorder hemophilia, who all their lives depend on outside sources for clotting factors they lack.

Genetically engineered Kogenate was licensed Feb. 28, 1993, by the Food and Drug Administration as the second non-blood-derived alternative for people without clotting factor VIII. FDA licensed the first non-blood factor VIII, Recombinate, in December 1992. These products are for patients with hemophilia A. They prevent or control bleeding and prevent bleeding associated with surgery.

Previously, factor VIII could only be obtained from products derived from human plasma, the liquid part of blood. Kogenate and Recombinate are produced by hamster ovary cells into which the gene for human factor VIII has been inserted. The resulting factor is highly purified, eliminating the risk of transmission of viruses such as hepatitis or HIV, the virus that causes AIDS.

The new drug Trasylol Injection (aprotinin), approved last Dec. 29, decreases the need for transfusion in patients undergoing coronary artery bypass surgery. (For more biological and drug alternatives, see "Approved Alternatives.")

In addition to drugs and biologics, several medical practices are available to lessen the already low risk of disease transmission. These alternatives include using the patient's own previously donated blood, recycling the patient's blood shed during surgery, and diluting the patient's blood before surgery.

Your Own Blood

Patients who are likely to require a transfusion during an upcoming surgery may decide to donate their own blood for possible reinfusion. FDA recommends this practice, called "autologous" transfusion, whenever possible for elective surgery.

Use of the patient's own blood may reduce the chance of infection or other adverse reaction. The practice also decreases demand on the public blood supply. In addition, autologous transfusion allows blood lost during surgery to be replaced more quickly because the process of donating blood, in itself, stimulates the bone marrow to produce new blood cells.

The disadvantages include: increased cost (about $24 more per unit), unnecessary donation if surgery doesn't require transfusion, and sometimes waste of unneeded units. Autologous blood not used by the donor-patient often cannot be used by another patient.

Some hospitals have a program for using autologous units in the public blood supply if the intended patient doesn't use them. These units must meet all FDA's safety standards for regular transfusion. In fact, the agency strongly recommends that all tests routinely performed on regular donations be performed on all autologous donations. Uniform testing is less confusing and safer, because it decreases the chance of releasing for general use an incompletely tested unit of blood. Labeling of an autologous donation must clearly indicate the intended recipient. Liquid blood can be stored refrigerated only 42 days; frozen blood, 10 years.

Autologous blood is most widely used for surgery on the bones, blood vessels, urinary tract, and heart. Nevertheless, any medically stable patient, even a child or pregnant woman, can be a candidate for autologous donation, according to Joseph Fratantoni, M.D., director of hematology at FDA's Center for Biologics Evaluation and Research.

Conditions that might prevent someone from donating blood for others don't necessarily prevent autologous blood donation. For example, people who have had hepatitis may give blood to themselves. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Alternatives to Regular Blood Transfusions
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.