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TitleAlternative Approaches to Human Blood Resources in Clinical Practice [electronic resource] : Proceedings of the Twenty-Second International Symposium on Blood Transfusion, Groningen 1997, organized by the Red Cross Blood Bank Noord Nederland / edited by C. Th. Smit Sibinga, P. C. Das, J. C. Fratantoni
ImprintBoston, MA : Springer US : Imprint: Springer, 1998
Connect tohttp://dx.doi.org/10.1007/978-1-4615-5619-0
Descript XVI, 260 p. online resource

SUMMARY

Currently blood is a volatile issue. The safety of blood and the quantification of transfusion risks have been dominant themes that have stimulated the development of alternative approaches in this rapidly developing area. In clinical medicine conventional blood and its components are used in supportive therapies dependent on the choice of apparent uncritical trigger factors. A compounding factor is depth of prospective clinical trials for evidence. Such trials in critical care areas would be of enormous value, not only in recording adverse effects and under-transfusion, but also indicating the value of decision analysis and cost-effectiveness in transfusion practice. Alternative approaches include the use of cytokines, growth factors, humanised monoclonal antibodies, recombinant plasma factors, and buffy coat derived natural human interferons. These are being increasingly implemented in the clinic. Solutions for oxygen transport are being developed and fibrinogen coated microcapsules are being investigated for thrombocytopenia. In surgical patients, various crystalloid and colloid combinations are explored as volume replacements. To avoid allogeneic transfusions, beneficial blood saving methods include various strategies, such as autologous deposits, normovolemic haemodilution and various agents including aprotinin, tranecamic acid, desmopressin and erythropoietin, but their use in hospital shows considerable variations. That umbilical cord blood could be a significant source of allogeneic stem cells in related and unrelated transplantation is illustrated by the increasing number of cord blood banks in Europe and elsewhere. Future blood resources are likely to face several challenges: immediate challenges relate to increased regulatory and political oversights; intermediate solutions would offer some improvements in public health and alleviate public fear but probably not address the economic challenges thrust upon the medical care system. As we approach the year 2000, the major concerns about transfusion medicine remain its logistics, safety and effectiveness. This theme is presented in the proceedings of the 22nd International Symposium on Blood Transfusion, developed in 21 up-to-date topics, collected and discussed in four sections. This book will be of timely value to students, professionals and all others interested or involved in the field of transfusion medicine, whether clinical or related


CONTENT

I. The Clinical Setting: How to Optimise Supportive Haemotherapy -- Principles of Supportive Haemotherapy -- What Should Trigger a Transfusion? -- The Efficacy of Technologies to Minimise Peri-Operative Allogeneic Transfusion -- Evidence-Based Transfusion Medicine or the Need to Evaluate Clinical Outcome -- Discussion -- II. Chemical and Biological Alternatives -- The Role of O2 Transport in the Development of the Transfusion Trigger -- Recombinant Human Erythropoietin โ{128}{148} Could It Be Used in a Better Way? -- The Impact of Haematopoietic Growth Factors on Supportive Care in Clinical Oncology: With Special Attention to Potential Tumour Cell Contamination in the Stem Cell Harvest -- The Development of Synthocytesโ{132}ข, a Novel Platelet Substitute -- Recent Developments in the Construction of Bispecific Antibodies -- Re-Appraising the Waste Status of Buffy Coats: Natural Human Interferon -- Discussion -- III. Alternative Approaches in Clinical Practice -- Volume: A Matter of Replacement -- The Management of Anaemia in the Surgical Patient: Whatโ{128}{153}s New? -- How to Save Blood: Alternative Approaches in Anaesthesiology and Surgery -- The Use of Technologies to Decrease Perioperative Allogeneic Blood Transfusion: An International Survey of Practice -- Umbilical Cord Blood as an Alternative Source of Haematopoietic Stem Cells for Transplantation -- Cord Blood Banking and Transplant in Europe -- Discussion -- IV. The Balance of Risks, Benefits and Costs -- Indications for Red Blood Cell Transfusion -- Cost-Effectiveness of Conventional and Alternative Approaches in Transfusion Practice: The Value of Decision Analysis -- The Design of Transfusion in Randomised Controlled Trials in Critically I11 Patients -- The Future of Human Blood Resources -- Discussion


Medicine Anesthesiology Critical care medicine Cardiology Surgery Medicine & Public Health Surgery Anesthesiology Intensive / Critical Care Medicine Cardiology



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