Oxygen Carriers ‐ What is Behind Us? What is Ahead?

Abstract

New emphasis is upon other complications of transfusion. The literature showing that transfusion of components containing white cells acts as a immunosuppressant is growing steadily [1][2][3][4][5][6][7][8][9] . In orthopedic and cardiac surgery, recent articles are suggesting that transfusion of allogeneic red cells with white cells present may increase the risk of infection up to 3.5 fold. This leads to a much greater morbidity and mortality as well as cost to the individual and society. Past thinking had been that autologous blood transfusion was relatively cost ineffective because of the rarity of viral infections. However, a new computer model of quality-adjusted-life-year (QALY), including the cost of immunosuppression, shows that autologous blood becomes very cost effective 5 . In Europe, a lay interest has focused on bovine spongiform encephalopathy and although no demonstrable cases