Alternatives to blood transfusion

Lancet. 2013 May 25;381(9880):1855-65. doi: 10.1016/S0140-6736(13)60808-9.


The use of alternatives to allogeneic blood continues to rest on the principles that blood transfusions have inherent risks, associated costs, and affect the blood inventory available for health-care delivery. Increasing evidence exists of a fall in the use of blood because of associated costs and adverse outcomes, and suggests that the challenge for the use of alternatives to blood components will similarly be driven by costs and patient outcomes. Additionally, the risk-benefit profiles of alternatives to blood transfusion such as autologous blood procurement, erythropoiesis-stimulating agents, and haemostatic agents are under investigation. Nevertheless, the inherent risks of blood, along with the continued rise in blood costs are likely to favour the continued development and use of alternatives to blood transfusion. We summarise the current roles of alternatives to blood in the management of medical and surgical anaemias.

Publication types

  • Review

MeSH terms

  • Anemia / economics
  • Anemia / etiology
  • Anemia / prevention & control*
  • Antifibrinolytic Agents / therapeutic use
  • Blood Coagulation Disorders / prevention & control
  • Blood Loss, Surgical / prevention & control
  • Blood Transfusion / economics
  • Blood Transfusion / methods*
  • Chronic Disease
  • Costs and Cost Analysis
  • Erythropoiesis / physiology
  • Hematinics / therapeutic use
  • Hemorrhage / prevention & control
  • Hemostasis, Surgical / methods
  • Hemostatics / therapeutic use
  • Humans
  • Patient Care Planning
  • Point-of-Care Systems
  • Preoperative Care / methods
  • Professional Practice / standards
  • Thoracic Surgical Procedures / methods
  • Transfusion Reaction
  • Wounds and Injuries / surgery


  • Antifibrinolytic Agents
  • Hematinics
  • Hemostatics