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Artificial Oxygen Carriers Save Lives in Expanded Access Use: Three Cases when Blood Was Not an Option
Zhen W Mei1, Jay S Raval2, Justin Arnall3
1Transfusion Medicine, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Clinical Features:
Sickle cell patients may develop a multitude of antibodies and experience life-threatening events with transfusion such as hyperhemolysis syndrome or delayed hemolytic transfusion reaction. Further transfusion may not be possible in such cases.
Therapeutic Challenge:
When conventional blood products are not available for transfusion yet the patient requires additional oxygen-carrying support, artificial oxygen carriers may be required. However, there are no such FDA-approved products available.
Solution:
Emergency investigational new drug applications for a polymerized hemoglobin-based oxygen carrier (HBOC-201, Hemopure) were completed, and Expanded Access use was granted for these patients. HBOC-201 is an investigational bovine hemoglobin-based oxygen carrier. Herein, we report how acute resuscitation with HBOC-201 was potentially life saving while waiting for supportive therapy, erythropoietin, and/or immune modulatory drugs to take effect in all 3 patients.
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