Revisiting transfusion safety and alternatives to transfusion

SummaryTransfusion of blood products can be life saving when used appropriately. It carries however at the same time a potential for morbidity and mortality, depending on the patient, the product or the setting. Numerous strategies have been elaborated to minimize these risks, and in recent years, transfusion has no longer been regarded as essential for the management of a wide range of diseases. Uncomplicated surgeries in well-prepared patients can now be conducted without the use of transfusions. Questions about transfusion safety and shortage have led to extensive research on alternatives to blood transfusion, ranging from non-pharmacological to pharmacological solutions. Restrictive transfusion therapies, preoperative autologous blood donations, perioperative red cell salvage, acute normovolaemic haemodilution techniques or patient blood management are potential solutions where prothrombin complex or fibrinogen concentrates, synthetic anti-fibrinolytic agents, desmopressin, rFVIIa, or erythropoiesis stimulating agents may play a complementary pharmacologic role.In this issueBlood transfusion in 2016 – Towards a “Nouvelle Vague” therapy?Olivier Garraud, FranceEthics and blood donation: a marriage of convenienceJean-Daniel Tissot, Switzerland and Olivier Garraud, FrancePast, present and forecast of transfusion medicine: What has changed and what is expected to change?Amy E. Schmidt, Majed A. Refaai, Neil Blumberg, United StatesRethinking blood components and patients: Patient blood management. Possible ways for development in FranceGilles Folléa, FranceRed blood cell components: Meeting the quantitative and qualitative transfusion needsRichard O. Francis, and Steven L. Spitalnik, United StatesPlatelet concentrates: Balancing between efficacy and safety?Miguel Lozano, Joan Cid, SpainFocus on fresh frozen plasma – facilitating optimal management of bleeding through collaboration between clinicians and transfusion specialists on component specificationsSheila MacLennan, United KingdomThe infectious risks in blood transfusion as of today – A no black and white situationOlivier Garraud, Luiz Amorim Filho, Syria Laperche, Claude Tayou-Tagny, Bruno Pozzetto, France, Brazil, CamerounImmunological complications of blood transfusionsAnneke Brand, NetherlandsThe outsider adverse event in transfusion: InflammationElizabeth A. Godbey, Eldad A. Hod, United StatesRevisiting transfusion safety and alternatives to transfusionPatrick Schoettker, Carlos E. Marcucci, Gabriele Casso, Catherine Heim, Switzerland