Blood Substitutes

Blood substitutes are solutions designed for use in patients who need blood transfusions, but for whom whole blood is not available, or is not safe. This interest has intensified in the wake of the AIDS and hepatitis C epidemics. Blood Substitutes describes the rationale, current approaches, clinical efficacy, and design issues for all blood substitutes now in clinical trials. The many summary diagrams and tables help make the book accessible to readers such as surgeons and blood bankers, who have less technical expertise than the biochemists and hematologists who are designing and testing blood substitutes.

* Includes chapters necessary to the understanding of blood substitutes, including history, toxicity, physiology, and clinical applications
* Presents detailed descriptions of the various products that have been developed and have advanced to clinical trials, and some that are in earlier states of development

BACKGROUND
Historical Background
Transfusion Medicine
Regulatory Perspectives on Clinical Trials for Oxygen Therapeutics in Trauma and Transfusion Practice
PHYSIOLOGICAL BASIS
Clinical Physiology: Oxygen Transport and the Transfusion Trigger
The Role of Oxygen and Hemoglobin Diffusion in Oxygen Transport by Cell-Free Hemoglobins
Oxygen Transport Properties of Hemoglobin- Based Oxygen Carriers: Studies Using Artificial Capillaries and Mathematical Stimulation
Mechanisms of O2 Transport in the Microcirculation: Effects of Cell-Free O2 Carriers
Shear Stress, Mechanotransduction and the Flow Properties of Blood
Local Regulation of Blood Flow
CLINICAL APPLICATIONS
Clinical Indications for Blood Substitutes and Optimal Properties
Crystalloid Solutions
Hemoglobin-Based Oxygen Carriers as Resuscitative Solutions for Trauma and Combat Casualty Care
Surgical Hemorrhage
Clinical Trials in Cardiac Surgery
Hemodilution
Clinical Hemodilution
Potential for Blood Substitutes in Tissue Ischemia
TOXICITY AND SIDE EFFECTS
Redox and Radical Reactions of Hemoglobin Solutions: Toxicities and Protective Strategies
Pro-oxidant Activity of Hemoglobin and Endothelial Cytotoxicity
Renal Toxicity
Hemoglobin and Neurotoxicity
The Role of Inflammation in the Toxicity of Hemoglobin-based Oxygen Carriers
Hemoglobin-Induced Myocardial Lesions
PERFLUOROCARBON-BASED OXYGEN CARRIERS
Fluorocarbon Emulsions As In Vivo Oxygen Delivery Systems: Background And Chemistry
Fluosol: The First Commercial Injectable Perfluorocarbon Oxygen Carrier
Perftoran
Rational Development of OxyfluorT
OxygentT, a Perfluorochemical-Based Oxygen Therapeutic for Surgical Patients
HEMOGLOBIN-BASED OXYGEN CARRIERS
The Structural and Functional Properties of Hemoglobin and their Relevance for a Hemoglobin-based Blood Substitute
Hemoglobin Modification
Designing Recombinant Hemoglobin for Use as a Blood Substitute
Design, Conformational, Functional, and Physiological Characterization of Recombinant Polymeric Heme-Proteins
áá-Crosslinked Hb
DCLHb and rHb1.1
Studies with DCLHb
Hemopure® [Hboc-201, Hemoglobin Glutamer-250 (Bovine)]: Preclinical Studies
Hboc-201, [Hemoglobin Glutamer-250 (Bovine), Hemopure®]: Clinical Studies
Polyhemoglobin-Enzymes as New Generation Blood Substitutes and Oxygen Therapeutics
Surface Decoration of Hemoglobin with Polyethylene Glycol
HemospanT (MP4), a Human Hemoglobin Modified with Maleimide-Polyethylene Glycol
Dextran-Hemoglobin
Development of Non-extravasating, Hemoglobin-Based Oxygen Carriers
LIPOSOMES AND RELATED PRODUCTS
Liposome Encapsulated Hemoglobin: History, Preparation, and Evaluation
Hemoglobin-Vesicles as a Molecular Assembly:Characteristics of Preparation Process and Performances as Artificial Oxygen Carriers
Nanodimension Biodegradable Polymeric Membrane Artificial Red Blood Cells
Albumin-Heme: A Synthetic Heme-Based Oxygen Carrier
GLOSSARY
INDEX