Artificial Blood Substitutes Market

Artificial Blood Substitutes Market

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Raksha Sharma

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The artificial blood substitutes market size was valued at USD 6.8 Bn in 2022 and is likely to reach USD 35.50 Bn by 2031, expanding at a CAGR of 20.2% during 2023–2031. The market growth is driven by increasing demand for blood transfusions, shortage in blood supply, advancement in technology, and rising safety concerns and infections.

Artificial blood substitutes are created as a substitute for human blood during transfusions. They are specifically designed to perform the same vital function as real blood, which is transporting oxygen and nutrients throughout the body.

Artificial Blood Substitutes Market Outlook

These substitutes are made using various materials such as perfluorocarbons (PFCs), synthetic hemoglobin, and other substances. Additionally, artificial blood substitutes are beneficial in situations where donated blood is not accessible or unsuitable for transfusion.

Artificial blood is a special kind of blood substitute that helps deliver oxygen to the body when someone loses a lot of blood due to an injury or in emergency situations such as being injured during a battle. It can be used instead of real blood during surgeries, so blood transfusions are unnecessary.

The artificial blood substitute industry has been focused on developing and providing substitute products for real blood. These substitutes are used in medical settings, particularly for critically ill patients who require oxygen transport in their bodies.

Artificial blood substitutes are designed to perform the essential function of carrying oxygen and carbon dioxide, similar to real blood. In June 2020, scientists from the American Chemical Society tried to create synthetic red blood cells that work the same as real ones. These are the important things happening in the field of artificial blood.

Artificial blood substitutes are typically sterile and free from infectious agents, which reduces the risk of transmitting blood-borne infections, such as HIV or hepatitis. This is particularly beneficial in regions where the prevalence of such infections is high.

The market report finds that the COVID-19 pandemic has affected the artificial blood substitutes market. The outbreak lead to a decrease in blood supply due to various factors including the reduced number of blood donations and disruption in the healthcare system.

Post-pandemic period is expected a significant impact on artificial blood substitutes. The pandemic has highlighted the importance of ensuring a stable and reliable blood supply leading to increased recognition of the potential of artificial blood substitutes. Post-pandemic there is increasing focus on the development, research, and adoption of artificial blood substitutes to strengthen the blood supply chain and enhance patient care.

Global Artificial Blood Substitutes Market Dynamics

Artificial Blood Substitutes Market Dynamics

Major Drivers

Increasing usage of artificial blood substitutes is one of the factors driving the market. Artificial blood is created using various sources such as human blood,  animal blood, microorganisms, recombinant hemoglobin, stem cells, and other materials. The major advantage is that artificial blood belongs to a universal blood group, making it suitable for managing to patients regardless of their blood type.

This eliminates the need for blood group typing and reduces the risk of incompatible transfusions. Additionally, artificial blood substitutes do not cause immunological reactions, further enhancing their compatibility with patients.

Increasing awareness of the benefits offered by artificial blood among individuals is another factor expected to propel the market. The manufacturing process of blood substitutes includes trials to eliminate bacteria and viruses, thus reducing the risk of infectious diseases during blood transfusions. This is particularly significant in regions such as Sub-Saharan Africa where infectious diseases pose a major concern.

Existing Restraints

High cost associated with artificial blood products is anticipated to hamper the market. The growth rate of the artificial blood substitute market is likely to face obstacles due to the high cost of these products and the limited adoption in emerging and underdeveloped countries.

For instance, the duration of effectiveness for most hemoglobin-based artificial blood substitutes is typically limited to 20-30 hours in the body, whereas whole blood transfusions can last up to 34 days. Additionally, artificial blood substitutes lack the ability to mimic the disease-fighting and clotting functions of natural blood.

Emerging Opportunities

A growing number of surgical procedures being performed creates lucrative opportunities for the market. The increasing prevalence of surgical procedures boosts the demand for artificial blood substitutes as alternatives to donated human blood components such as plasma and red cells. Both government and private organizations are providing enhanced funding for research on artificial blood substitutes, leading to the development of innovative products.

For instance, Hemoglobin Oxygen Therapeutics LLC published preclinical data in April 2019, demonstrating the efficacy of their product, Hempure, in replacing packed red blood cells (RBCs) during normothermic kidney perfusion (NMP). This significant development generates interest in the field of organ transplantation.

Scope of the Global Artificial Blood Substitutes Market Report

The market report includes an assessment of the market trends, segments, and regional markets. Overview and dynamics have also been included in the report.

Attributes

Details

Report Title

Global Artificial Blood Substitutes Market - Global Industry Analysis, Growth, Share, Size, Trends, and Forecast

Base Year

2022

Historic Data

2016–2021

Forecast Period

2023–2031

Segmentation

Product Type (Perflurocarbon and Hemoglobin-Based Oxygen Carries), Source (Animal Blood, Human Blood, Synthetic Polymers, Stem Cells, and Microorganism Based Recombinant HB), Application (Cardiovascular Diseases, Injuries, Anemia, Organ Transplant,   Malignant Neoplasma, Neonatal Conditions,  and Maternal Condition), and End-user (Blood Banks, Hospital & Clinics, and Others)

Regional Scope

Asia Pacific, North America, Latin America, Europe, and Middle East & Africa

Report Coverage

Company Share, Market Analysis and Size, Competitive Landscape, Growth Factors, Market Trends, and Revenue Forecast

Key Players Covered in the Report

Aurum Bioscience; Hemoglobin Oxygen Therapeutics LLC; HEMARINA; KaloCyte, Inc.; NuvOx Pharma; Prolong Pharmaceuticals, LLC; and Boston Pharmaceuticals

Market Segment Insights

Based on product type, the artificial blood substitutes market is bifurcated into perfluorocarbon (PFCs) and hemoglobin-based oxygen carriers (HBOCs). The hemoglobin-based oxygen carriers (HBOCs) segment is expected to expand at a major growth rate during the projection period due to the increasing adoption of HBOC in blood transfusion procedures for trauma and emergency care settings.

HBOCs serve as a viable alternative to natural blood, offering a safe and efficient option for blood replacement treatments. HBOCs are designed to mimic the oxygen-carrying function of red blood cells, enabling them to effectively deliver oxygen to tissues and organs if needed.

This capability makes them valuable in critical situations where immediate oxygen delivery is crucial for patient survival. They can be stored for longer periods without the need for refrigeration, reducing logistical challenges and enhancing their availability in emergency situations.

The perfluorocarbon (PFCs) segment is expected to expand at a significant growth rate in the coming years due to its ability to transportation of oxygen efficiently within the bloodstream. Perfluorocarbons are used as artificial blood substitutes, it is man-made and contains compounds only fluorine and carbon.

PFCs are utilized as artificial blood substitutes because they have the ability to bind and carry oxygen molecules effectively. This property allows them to serve as reliable oxygen carriers and ensure oxygen delivery to vital organs and tissues. The efficient oxygen transport provided by PFCs makes it convenient in various medical applications for healthcare professionals, including situations where traditional blood transfusions can not be readily available or suitable. As a result, the PFC witnessing growth as healthcare professionals recognize the benefits of these substances in oxygen delivery and their potential to improve patient outcomes.

Artificial Blood Substitutes Market Product Type

On the basis of source, the artificial blood substitutes market is segregated into animal blood, human blood, synthetic polymers, stem cells, and microorganism based recombinant HB. The microorganism based recombinant HB is projected to register a considerable CAGR during the forecast period due to providing advantages in terms of scalability, cost-effectiveness, and control over the production process.

Microorganism-based recombinant HB involves the use of genetically modified microorganisms to produce hemoglobin, which can be used as a key component in artificial blood substitutes. The use of microorganisms allows for the production of large quantities of recombinant HB in a controlled laboratory setting. This scalability makes it easier to meet the increasing demand for artificial blood substitutes.

The process of genetically modifying microorganisms to produce HB can be cost-effective compared to other sources such as human or animal blood. It eliminates the need for continuous blood donations and reduces the risk of potential diseases or contamination associated with donated blood.

The synthetic polymers segment is anticipated to hold a significant share of the market due to improved safety and extended shelf life of the products. Synthetic polymers are engineered materials designed to mimic the oxygen-carrying function of natural blood. These polymers can be tailored to have the desired oxygen-carrying capacity and other properties necessary for artificial blood substitutes. Synthetic polymers provide the advantage of being readily available and free from potential contaminants.

Synthetic polymers offer advantages in terms of safety and compatibility. They can be designed to be biocompatible, meaning they are less likely to cause adverse reactions or immune responses when introduced into the body. This reduces the risk of complications during transfusion and increases patient safety. Synthetic polymers have a longer shelf life compared to natural blood products. They can be stored for extended periods without the need for refrigeration or specialized storage conditions, making them more convenient and readily available for emergency situations.

On the basis of application, the artificial blood substitutes market is segmented into cardiovascular diseases, injuries, anemia, organ transplant, malignant neoplasms, neonatal conditions,  and maternal conditions. The anemia segment is anticipated to register a robust growth rate during the forecast period due to increasing demand for effective and readily available solutions to address oxygen-carrying capacity shortfalls in anemic patients.

Anemia is a common medical condition characterized by a decrease in the number of red blood cells or a decrease in their ability to carry oxygen. Patients with severe anemia often require blood transfusions to restore their oxygen-carrying capacity. However, the availability of compatible blood for transfusion is often limited, and there can be challenges in finding suitable donors. They can provide an immediate and controlled supply of oxygen to the body and effectively address the oxygen deficiency experienced by anemic patients. These substitutes can help improve the symptoms associated with anemia, such as fatigue, weakness, and shortness of breath.

Artificial Blood Substitutes Market Application

Based on the end-user, the artificial blood substitute market is segregated into blood banks, hospital & clinics, and others. The hospital and clinics segment is expected to hold the largest share of the market due to the presence of specialized medical staff and infrastructure.

Hospitals and clinics are the primary healthcare institutions where patients receive medical treatments including blood transfusions. These facilities have a high demand for blood products including artificial blood substitutes, for the needs of patients undergoing various surgical procedures, emergency treatments, and critical care. They have the necessary equipment and expertise to monitor patients and manage any potential complications that can arise during the transfusion process.

The blood bank segment is projected to expand at a considerable growth rate during the projection period due to the extensive distribution network for the delivery of the products. Blood banks have a wide network and reach that serve various healthcare institutions including hospitals, clinics, and other medical facilities.

They act as a centralized hub for blood product distribution and blood collection, making them an essential link in the supply chain of artificial blood substitutes. Their extensive distribution network allows for efficient delivery and accessibility of these substitutes to healthcare providers and patients.

Regional Outlook

In terms of region, the global artificial blood substitutes market is classified as Asia Pacific, North America, Latin America, Europe, and Middle East & Africa. North America is expected to dominate the market during the projection period due to the increasing number of clinical trials and significant funding investments from government organizations and private institutions.

North America is home to a robust healthcare system and advanced medical research infrastructure. The region has a high concentration of renowned research institutions, hospitals, and pharmaceutical companies that actively engage in conducting clinical trials for various medical advancements in artificial blood substitutes.

Government organizations and private institutions recognize the potential of artificial blood substitutes to address the challenges associated with blood transfusions and improve patient outcomes. They also provide significant funding to research projects, clinical trials, and academic institutions focused on advancing the field of Artificial Blood Substitutes.

The market in Europe is anticipated to grow at a rapid pace owing to the presence of well-established healthcare infrastructure. This region is experiencing challenges related to the limited availability of fresh blood and the short shelf life of donated blood products. This lack of blood supply creates a significant demand for alternative solutions such as artificial blood substitutes.

Europe has witnessed a rising need for blood transfusions due to an aging population, an increasing prevalence of chronic diseases, and a growing number of surgical procedures. This region has a well-established healthcare infrastructure and strong regulatory frameworks that support the adoption and utilization of innovative medical technologies.

Artificial Blood Substitutes Market Region

Segments

Product Type

  • Perfluorocarbons
  • Hemoglobin-Based Oxygen Carries

Source

  • Animal Blood
  • Human Blood
  • Synthetic Polymers
  • Stem Cells
  • Microorganism Based Recombinant HB

Application

  • Cardiovascular Diseases
  • Injuries
  • Anaemia
  • Organ Transplant
  • Malignant Neoplasma
  • Neonatal Conditions
  • Maternal Condition

End-user

  • Blood Banks
  • Hospital & Clinics
  • Others

Region

  • Asia Pacific
  • North America
  • Latin America
  • Europe
  • Middle East & Africa

Key Players

  • Aurum Biosciences
  • Hemoglobin Oxygen Therapeutics LLC
  • HEMARINA
  • KaloCyte, Inc.
  • NuvOx Pharma
  • Prolong Pharmaceuticals, LLC
  • Boston Pharmaceuticals

Competitive Landscape

Key players competing in the global artificial blood substitutes market are Aurum Bioscience; Hemoglobin Oxygen Therapeutics LLC; HEMARINA; KaloCyte, Inc.; NuvOx Pharma; Prolong Pharmaceuticals, LLC; and Boston Pharmaceuticals

These major players in the artificial blood substitutes market are developing various strategies including mergers, collaboration, innovation acquisitions, partnerships, and new product launches, to expand their offerings, technological advancements, and consumer base. These companies are recognized for For instance,

  • In September 2022, VirTech Bio secured funding from the Pentagon, U.S. Department of Defense (DoD), to support the clinical research phase of their hemoglobin-based blood-like oxygen-carrying solution, refers as OxyBridge. This funding valued at USD 13 million, aims to drive the development and testing of the product, which is designed to prevent hemorrhagic shock in trauma patients and enhance the viability of donated organs for transplantation.

Artificial Blood Substitutes Market Key Players

1. Executive Summary
2. Assumptions and Acronyms Used
3. Research Methodology
4. Artificial Blood Substitutes Market Overview
  4.1. Introduction
     4.1.1. Market Taxonomy
     4.1.2. Market Definition
  4.2. Macro-Economic Factors
     4.2.1. Industry Outlook
  4.3. Artificial Blood Substitutes Market Dynamics
     4.3.1. Market Drivers
     4.3.2. Market Restraints
     4.3.3. Opportunity
     4.3.4. Market Trends
  4.4. Artificial Blood Substitutes Market - Supply Chain
  4.5. Global Artificial Blood Substitutes Market Forecast
     4.5.1. Artificial Blood Substitutes Market Size (US$ Mn) and Y-o-Y Growth
     4.5.2. Artificial Blood Substitutes Market Size (000’ Units) and Y-o-Y Growth
     4.5.3. Artificial Blood Substitutes Market Absolute $ Opportunity
5. Global Artificial Blood Substitutes Market Analysis and Forecast by Applications
  5.1. Market Trends
  5.2. Introduction
     5.2.1. Basis Point Share (BPS) Analysis by Applications
     5.2.2. Y-o-Y Growth Projections by Applications
  5.3. Artificial Blood Substitutes Market Size and Volume Forecast by Applications
     5.3.1. Cardiovascular Diseases
     5.3.2. Injuries
     5.3.3. Anaemia
     5.3.4. Organ Transplant
     5.3.5. Malignant Neoplasma
     5.3.6. Neonatal Conditions
     5.3.7. Maternal Condition
  5.4. Absolute $ Opportunity Assessment by Applications
  5.5. Market Attractiveness/Growth Potential Analysis by Applications
6. Global Artificial Blood Substitutes Market Analysis and Forecast by End Users
  6.1. Market Trends
  6.2. Introduction
     6.2.1. Basis Point Share (BPS) Analysis by End Users
     6.2.2. Y-o-Y Growth Projections by End Users
  6.3. Artificial Blood Substitutes Market Size and Volume Forecast by End Users
     6.3.1. Blood Banks
     6.3.2. Hospital & Clinics
     6.3.3. Others
  6.4. Absolute $ Opportunity Assessment by End Users
  6.5. Market Attractiveness/Growth Potential Analysis by End Users
7. Global Artificial Blood Substitutes Market Analysis and Forecast by Region
  7.1. Market Trends
  7.2. Introduction
     7.2.1. Basis Point Share (BPS) Analysis by Region
     7.2.2. Y-o-Y Growth Projections by Region
  7.3. Artificial Blood Substitutes Market Size and Volume Forecast by Region
     7.3.1. North America
     7.3.2. Latin America
     7.3.3. Europe
     7.3.4. Asia Pacific
     7.3.5. Middle East and Africa (MEA)
  7.4. Absolute $ Opportunity Assessment by Region
  7.5. Market Attractiveness/Growth Potential Analysis by Region
  7.6. Global Artificial Blood Substitutes Demand Share Forecast, 2019-2026
8. North America Artificial Blood Substitutes Market Analysis and Forecast
  8.1. Introduction
     8.1.1. Basis Point Share (BPS) Analysis by Country
     8.1.2. Y-o-Y Growth Projections by Country
  8.2. North America Artificial Blood Substitutes Market Size and Volume Forecast by Country
     8.2.1. U.S.
     8.2.2. Canada
  8.3. Absolute $ Opportunity Assessment by Country
  8.4. North America Artificial Blood Substitutes Market Size and Volume Forecast by Applications
     8.4.1. Cardiovascular Diseases
     8.4.2. Injuries
     8.4.3. Anaemia
     8.4.4. Organ Transplant
     8.4.5. Malignant Neoplasma
     8.4.6. Neonatal Conditions
     8.4.7. Maternal Condition
  8.5. Basis Point Share (BPS) Analysis by Applications
  8.6. Y-o-Y Growth Projections by Applications
  8.7. North America Artificial Blood Substitutes Market Size and Volume Forecast by End Users
     8.7.1. Blood Banks
     8.7.2. Hospital & Clinics
     8.7.3. Others
  8.8. Basis Point Share (BPS) Analysis by End Users
  8.9. Y-o-Y Growth Projections by End Users
  8.10. Market Attractiveness/Growth Potential Analysis
     8.10.1. By Country
     8.10.2. By Product Type
     8.10.3. By Application
  8.11. North America Artificial Blood Substitutes Demand Share Forecast, 2019-2026
9. Latin America Artificial Blood Substitutes Market Analysis and Forecast
  9.1. Introduction
     9.1.1. Basis Point Share (BPS) Analysis by Country
     9.1.2. Y-o-Y Growth Projections by Country
     9.1.3. Latin America Average Pricing Analysis
  9.2. Latin America Artificial Blood Substitutes Market Size and Volume Forecast by Country
      9.2.1. Brazil
      9.2.2. Mexico
      9.2.3. Rest of Latin America
   9.3. Absolute $ Opportunity Assessment by Country
  9.4. Latin America Artificial Blood Substitutes Market Size and Volume Forecast by Applications
     9.4.1. Cardiovascular Diseases
     9.4.2. Injuries
     9.4.3. Anaemia
     9.4.4. Organ Transplant
     9.4.5. Malignant Neoplasma
     9.4.6. Neonatal Conditions
     9.4.7. Maternal Condition
  9.5. Basis Point Share (BPS) Analysis by Applications
  9.6. Y-o-Y Growth Projections by Applications
  9.7. Latin America Artificial Blood Substitutes Market Size and Volume Forecast by End Users
     9.7.1. Blood Banks
     9.7.2. Hospital & Clinics
     9.7.3. Others
  9.8. Basis Point Share (BPS) Analysis by End Users
  9.9. Y-o-Y Growth Projections by End Users
  9.10. Market Attractiveness/Growth Potential Analysis
     9.10.1. By Country
     9.10.2. By Product Type
     9.10.3. By Application
  9.11. Latin America Artificial Blood Substitutes Demand Share Forecast, 2019-2026
10. Europe Artificial Blood Substitutes Market Analysis and Forecast
  10.1. Introduction
     10.1.1. Basis Point Share (BPS) Analysis by Country
     10.1.2. Y-o-Y Growth Projections by Country
     10.1.3. Europe Average Pricing Analysis
  10.2. Europe Artificial Blood Substitutes Market Size and Volume Forecast by Country
     10.2.1. Germany
     10.2.2. France
     10.2.3. Italy
     10.2.4. U.K.
     10.2.5. Spain
     10.2.6. Russia
     10.2.7. Rest of Europe
  10.3. Absolute $ Opportunity Assessment by Country
  10.4. Europe Artificial Blood Substitutes Market Size and Volume Forecast by Applications
     10.4.1. Cardiovascular Diseases
     10.4.2. Injuries
     10.4.3. Anaemia
     10.4.4. Organ Transplant
     10.4.5. Malignant Neoplasma
     10.4.6. Neonatal Conditions
     10.4.7. Maternal Condition
  10.5. Basis Point Share (BPS) Analysis by Applications
  10.6. Y-o-Y Growth Projections by Applications
  10.7. Europe Artificial Blood Substitutes Market Size and Volume Forecast by End Users
     10.7.1. Blood Banks
     10.7.2. Hospital & Clinics
     10.7.3. Others
  10.8. Basis Point Share (BPS) Analysis by End Users
  10.9. Y-o-Y Growth Projections by End Users
  10.10. Market Attractiveness/Growth Potential Analysis
     10.10.1. By Country
     10.10.2. By Product Type
     10.10.3. By Application
  10.11. Europe Artificial Blood Substitutes Demand Share Forecast, 2019-2026
11. Asia Pacific Artificial Blood Substitutes Market Analysis and Forecast
  11.1. Introduction
     11.1.1. Basis Point Share (BPS) Analysis by Country
     11.1.2. Y-o-Y Growth Projections by Country
     11.1.3. Asia Pacific Average Pricing Analysis
  11.2. Asia Pacific Artificial Blood Substitutes Market Size and Volume Forecast by Country
     11.2.1. China
     11.2.2. Japan
     11.2.3. South Korea
     11.2.4. India
     11.2.5. Australia
     11.2.6. Rest of Asia Pacific (APAC)
  11.3. Absolute $ Opportunity Assessment by Country
  11.4. Asia Pacific Artificial Blood Substitutes Market Size and Volume Forecast by Applications
     11.4.1. Cardiovascular Diseases
     11.4.2. Injuries
     11.4.3. Anaemia
     11.4.4. Organ Transplant
     11.4.5. Malignant Neoplasma
     11.4.6. Neonatal Conditions
     11.4.7. Maternal Condition
  11.5. Basis Point Share (BPS) Analysis by Applications
  11.6. Y-o-Y Growth Projections by Applications
  11.7. Asia Pacific Artificial Blood Substitutes Market Size and Volume Forecast by End Users
     11.7.1. Blood Banks
     11.7.2. Hospital & Clinics
     11.7.3. Others
  11.8. Basis Point Share (BPS) Analysis by End Users
  11.9. Y-o-Y Growth Projections by End Users
  11.10. Market Attractiveness/Growth Potential Analysis
     11.10.1. By Country
     11.10.2. By Product Type
     11.10.3. By Application
  11.11. Asia Pacific Artificial Blood Substitutes Demand Share Forecast, 2019-2026
12. Middle East & Africa Artificial Blood Substitutes Market Analysis and Forecast
  12.1. Introduction
     12.1.1. Basis Point Share (BPS) Analysis by Country
     12.1.2. Y-o-Y Growth Projections by Country
     12.1.3. Middle East & Africa Average Pricing Analysis
  12.2. Middle East & Africa Artificial Blood Substitutes Market Size and Volume Forecast by Country
     12.2.1. Saudi Arabia
     12.2.2. South Africa
     12.2.3. UAE
     12.2.4. Rest of Middle East & Africa (MEA)
  12.3. Absolute $ Opportunity Assessment by Country
  12.4. Middle East & Africa Artificial Blood Substitutes Market Size and Volume Forecast by Applications
     12.4.1. Cardiovascular Diseases
     12.4.2. Injuries
     12.4.3. Anaemia
     12.4.4. Organ Transplant
     12.4.5. Malignant Neoplasma
     12.4.6. Neonatal Conditions
     12.4.7. Maternal Condition
  12.5. Basis Point Share (BPS) Analysis by Applications
  12.6. Y-o-Y Growth Projections by Applications
  12.7. Middle East & Africa Artificial Blood Substitutes Market Size and Volume Forecast by End Users
     12.7.1. Blood Banks
     12.7.2. Hospital & Clinics
     12.7.3. Others
  12.8. Basis Point Share (BPS) Analysis by End Users
  12.9. Y-o-Y Growth Projections by End Users
  12.10. Market Attractiveness/Growth Potential Analysis
     12.10.1. By Country
     12.10.2. By Product Type
     12.10.3. By Application
  12.11. Middle East & Africa Artificial Blood Substitutes Demand Share Forecast, 2019-2026
13. Competition Landscape
  13.1. Global Artificial Blood Substitutes Market: Market Share Analysis
  13.2. Artificial Blood Substitutes Distributors and Customers
  13.3. Artificial Blood Substitutes Market: Competitive Dashboard
  13.4. Company Profiles (Details: Overview, Financials, Developments, Strategy)
     13.4.1. Aurum Biosciences
     13.4.2. Hemoglobin Oxygen Therapeutics LLC
     13.4.3. HEMARINA
     13.4.4. KaloCyte, Inc.
     13.4.5. NuvOx Pharma
     13.4.6. Prolong Pharmaceuticals, LLC
     13.4.7. Boston Pharmaceuticals

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