Hemoglobin-Based Oxygen Carriers: Where Are We Now in 2023?

Area of Science:

• Biomedical Engineering
• Hematology
• Pharmacology

Background:

• The search for effective blood substitutes, termed oxygen therapeutics, has been ongoing for over 100 years with limited success in clinical settings for severe anemia.
• Oxygen therapeutics are broadly categorized into hemoglobin-based oxygen carriers (HBOCs) and perfluorocarbon-based oxygen carriers.
• Despite extensive research, no universally accepted artificial blood product is available for human transfusion.

Purpose of the Study:

• To review the development and clinical status of hemoglobin-based oxygen carriers (HBOCs).
• To identify previously developed but discontinued HBOCs and those currently in active clinical research.
• To assess the future prospects of the oxygen therapeutics field.

Main Methods:

• Literature review of developed and discontinued hemoglobin-based oxygen therapeutics.
• Analysis of clinical trial status and regulatory approvals for various HBOCs.
• Synthesis of information on the historical development and future trends in oxygen therapeutics.

Main Results:

• Several HBOCs, including HemAssist, PolyHeme, Hemolink, Hemospan, and Hemoximer, have been discontinued.
• Hemopure is approved for clinical use in South Africa and Russia; its veterinary counterpart, Oxyglobin, is approved in the EU and US.
• HemO2life is approved for organ preservation in the EU, while OxyVita and Sanguinate are in active clinical studies.

Conclusions:

• The field of hemoglobin-based oxygen carriers has faced significant setbacks but shows emerging promise.
• Approved applications for veterinary use and organ preservation suggest potential diversification of HBOCs.
• The oxygen therapeutics field is poised for substantial growth in the next 10-20 years, driven by ongoing research and development.