Blood is a fluid connective tissue where living cells are suspended in
non-cellular liquid matrix. The cellular components of blood render gas exchange (RBCs),
immune surveillance (WBCs) and hemostatic responses (platelets), and the non-cellular
components (salts, proteins etc.) provide nutrition to various tissues in the body.
Dysfunction and deficiencies in these blood components can lead to significant tissue
morbidity and mortality. Consequently, transfusion of whole blood or its components is a
clinical mainstay in the management of trauma, surgery, myelosuppression and congenital
blood disorders. However, donor-derived blood products suffer from issues of shortage in
supply, need for type matching, high risks of pathogenic contamination, limited
portability and shelf-life, and a variety of side-effects. While robust research is being
directed to resolve these issues, a parallel clinical interest has developed towards
bioengineering of synthetic blood substitutes that can provide blood’s functions
while circumventing the above problems. Nanotechnology has provided exciting approaches to
achieve this, using materials engineering strategies to create synthetic and
semi-synthetic RBC substitutes for enabling oxygen transport, platelet substitutes for
enabling hemostasis and WBC substitutes for enabling cell-specific immune response. Some
of these approaches have further extended the application of blood cell-inspired synthetic
and semi-synthetic constructs for targeted drug delivery and nanomedicine. The current
article will provide a comprehensive review of the various nanotechnology approaches to
design synthetic blood cells, along with a critical discussion of successes and challenges
of the current state-of-art in this field.