Effects of hemoglobin glutamer-250 (bovine) (HBOC-201, Hemopure) on coagulation testing

Polymerized bovine hemoglobin is currently under investigation as an alternative to blood-banked human red blood cells. Because of the dark red hemolyzed appearance of hemoglobin-based oxygen carrier (HBOC)-201, we sought to describe the effects of HBOC-201 on coagulation analyzers that perform prothrombin times, activated partial thromboplastin times, fibrinogen, and antithrombin. Pooled normal plasma was combined with HBOC-201 to achieve plasma hemoglobin levels of 1.4, 2.6, 3.8, 4.8, and 6.2 g/dL. Results for each test using HBOC-201-prepared plasma were compared with results using saline-matched controls. Two consecutive absolute result differences of >10% between saline controls and HBOC-201 samples were used for determining interference in test accuracy by the concentration of HBOC-201. Mechanical detection methods (fibrometer, STA, CS-190) and the MDA-180 method were less affected by increasing levels of HBOC-201 than optical detection devices for all test parameters.