18. Alternatives to Allogeneic Transfusion

  1. Harvey G. Klein MD1 and
  2. David J. Anstee PhD, FRCPath, FMedSci2

Published Online: 30 NOV 2013

DOI: 10.1002/9781118689943.ch18

Mollison's Blood Transfusion in Clinical Medicine, Twelfth Edition

Mollison's Blood Transfusion in Clinical Medicine, Twelfth Edition

How to Cite

Klein, H. G. and Anstee, D. J. (eds) (2014) Alternatives to Allogeneic Transfusion, in Mollison's Blood Transfusion in Clinical Medicine, Twelfth Edition, John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118689943.ch18

Editor Information

  1. 1

    Chief, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA

  2. 2

    Director of the Bristol Institute for Transfusion Sciences, NHS Blood and Transplant; Honorary Professor of Transfusion Sciences, University of Bristol, Bristol, UK

Publication History

  1. Published Online: 30 NOV 2013
  2. Published Print: 24 JAN 2014

ISBN Information

Print ISBN: 9781405199407

Online ISBN: 9781118689943

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Keywords:

  • allogeneic transfusion;
  • anaphylaxis;
  • autologous transfusion;
  • erythropoietin;
  • haemorrhage;
  • haemostatic disorders;
  • recombinant human erythropoietin (rhEPO);
  • thrombin

Summary

This chapter addresses strategies for autologous transfusion, various blood-derived biologicals, non-blood-derived drugs and strategies to prevent haemorrhage and manage haemostatic disorders. The criteria for accepting donors for autologous transfusion need not be as strict as those for allogeneic transfusion. Preoperative assessment can identify anemia with correctable cause and contribute to avoidance of allogeneic transfusion. The major cause of anaemia in patients with end-stage renal disease is a lack of production of erythropoietin. The major side-effects of treatment with recombinant human erythropoietin (rhEPO) are hypertension and thrombotic episodes, originally thought to be related primarily to excessive doses and too rapid correction of anaemia. Anaphylaxis, the major toxicity associated with vitamin K, is rare, but dramatic. Thrombin is a potent plasma-derived enzyme that is formed from prothrombin as a result of activation of the intrinsic and extrinsic coagulation pathways.