ABSTRACT
The availability of recombinant human cytokines and growth factors is dra matically changing the practice of transfusion medicine. Previously, anemia, neutropenia, and thrombocytopenia were corrected by the transfusion of the appropriate cell type: red blood cells for anemia, granulocyte preparations for neutropenia, and platelet concentrates for thrombocytopenia. However, transfusion of cellular blood products carries with it the possibility of a num ber of undesirable side effects, including allosensitization, febrile reactions to neutrophils and monocytes and, although increasingly rare, the possibility of transmission of viral or other infectious agents including the human immu nodeficiency virus (HIV) (the virus that causes acquired immunodeficiency syndrome [AIDS]) and the hepatitis viruses (hepatitis B, hepatitis C, and, most recently, hepatitis G). Thus, considerable effort has been made to pro duce strategies to reduce patient exposure to blood products. Some of these strategies are mechanical, such as intraoperative blood salvage and perisurgical hemodilution. These strategies, while partially effective, have now been supplemented by products of recombinant DNA technology.
