Alternative Blood Products and Clinical Needs in Transfusion Medicine

Table 1

Cell sources for ex vivo generation of red blood cells*.

Cell type	Source	Special consent required	Advantages	Disadvantages
Peripheral blood mononuclear cells (PBMCs)	By product of leukoreduction	No	Donor with known phenotype	Limited expansion capacity
	Apheresis collection	Yes	≥3 products from single collection	Donors may become ineligible
	Mobilizing agent before apheresis	Yes (for mobilization and apheresis)	Expansion similar to cord blood with humanized media	Quality control requirement greater than blood
Cord blood	Low volume units unsuitable for transplantation	Yes	Hematopoietic progenitor cell number > PBMC 3–50 products phenotype must be determined	Multiple donations not possible
				Quality control moderately complex
iPSC	Fibroblast cultures from autologous or allogenic donors of known phenotype	Yes (for skin biopsy, fibroblast culture, and induction of pluripotency)	Unlimited expansion capacity	Quality control highly complex
hESC	Human embryos ≃1200 cell lines available	Yes	Unlimited expansion capacity	Ethical limitations on development and use
				Quality control highly complex

*Bacterial, mycoplasma, fungal, or viral contamination possible.