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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.
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.
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