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Hepatic reticuloendothelial function following resuscitation with hemoglobin solutions.
1Department of Surgery, Brown University/Miriam Hospital, Providence, RI 02906.
Summary
Red blood cell substitutes, like hemoglobin solutions, do not impair the reticuloendothelial system's ability to clear particles. Studies show no significant changes in liver particulate clearance or Kupffer cell function after transfusion.
Area of Science:
- Biomedical Engineering
- Physiology
- Immunology
Background:
- Red cell substitutes are being developed to address blood shortages.
- Potential impact on reticuloendothelial (RE) system function is a concern.
- The RE system is crucial for clearing foreign particles and pathogens.
Purpose of the Study:
- To investigate the effect of hemoglobin-based red cell substitutes on RE particulate clearance function.
- To determine if stroma-free hemoglobin (SFH) or polyhemoglobin (PHS) alter hepatic RE function.
- To assess the phagocytic capacity of Kupffer cells after exposure to hemoglobin solutions.
Main Methods:
- An animal model of hypovolemia-resuscitation was employed using Sprague-Dawley rats.
- Hemorrhaged rats underwent isovolumic replacement with SFH, PHS, or shed blood (SB).
- Hepatic RE function was measured by colloidal carbon clearance; Kupffer cell phagocytosis was assessed in vitro.
Main Results:
- Exchange transfusion with hemoglobin solutions did not significantly alter hepatic carbon clearance compared to SB controls (P > 0.05).
- In vitro phagocytic function of Kupffer cells incubated with SFH was not significantly different from bovine albumin-treated cells (P > 0.05).
Conclusions:
- Hemoglobin-based red cell substitutes do not appear to depress hepatic reticuloendothelial particulate clearance function.
- These findings suggest that SFH and PHS are safe regarding RE system function in this model.
- Further research may explore long-term effects and different types of red cell substitutes.