Search for the ideal blood substitute – current status

Synthetic blood substitutes are substances produced to fulfill functions of biological blood and serve as it’s replacers in diverse medical procedures. Their main function is to restore blood volume and deliver oxygen to tissues. Colloid solutions currently in use lack the ability to bind oxygen and are applied as blood serum equivalents only. Two classes of oxygen-carrying agents are being developed: hemoglobinbased oxygen carriers (HBOCs) and perfluorocarbon emulsions (PFCEs). HBOCs comprise of modified stroma-free hemoglobin and their preparation Hemopure is approved for use in the Republic of South Africa. Other HBOCs products are completing advanced clinical trials in Europe and USA. PFCs are chemical compounds with a different oxygen-binding mechanism than hemoglobin, resulting from their spatial conformation. In Russia, Mexico and China a formulation of PFC has been registered for use, however it did not get the FDA approval due to undesirable side effects. Both HBOCs and PFCs require extended clinical research before entering the market. Nevertheless, inadequate supply of fresh blood and complications associated with allogeneic blood transfusions make synthetic blood substitutes a promising alternative especially on field of emergency and military medicine.