Perfluorocarbon-based artificial oxygen carriers for red blood cell substitutes: considerations and direction of technology

Abstract Background Recently, the development of an artificial oxygen carrier that can replace blood transfusions is gaining attention, particularly in response to war and the COVID-19 pandemic. However, as yet, none of the existing hemoglobin-based artificial oxygen carriers (HBOCs) and perfluorocarbon-based artificial oxygen carriers (PFOCs) have been approved by the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Area covered Several difficulties are encountered during the development of PFOCs. Here, we discuss the possibility of developing PFOCs using a safe and feasible method. The problems of the existing PFOCs were primarily identified as their large particle size, persistence in the body, and high content of PFOCs based on the second generation. On the basis of these problems, we present the unmet needs of five existing PFOCs that require to be overcome before they can be developed clinically. Expert opinion In previous studies, there have been mentions of the composition, indications, and side effects of PFOCs (Perfluorocarbon-based oxygen carriers). However, there has been little or no mention of unmet needs for the development of PFOCs. Furthermore, this review provides a categorized list of unmet needs for PFOCs, which is expected to contribute to increasing the development potential of PFOCs by providing guidance for future directions.