The best replacement for bloodthirster is blade of the ruined king.

The best alternatives to bloodthirster are rated as following:
★★★★★  blade of the ruined king
★★★★★  infinity edge
★★★  ravenous hydra
★★  ravenous hydra riven
★★  infinity edge caitlyn
★★  last whisper
★★  hydra
★★  trinity force
★★  botrk vayne
★  botrk
★  sanguine blade
★  infinity edge vayne
★  balrog
★  hydra riven
★  hydra lee sin
★  black cleaver
★  trinity force ezreal
★  avatar
  ruined king
  avatar of khaine
  trinity force lucian

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