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[Modified hemoglobins as oxygen transporting blood substitutes ]
1Institut für Anästhesiologie und Operative Intensivmedizine, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg.
Der Anaesthesist
|January 1, 1995
Summary
Developing effective hemoglobin-based oxygen carriers (HBOCs) for clinical use has faced challenges for a century. Recent modifications address efficacy and safety concerns, paving the way for potential human trials.
Area of Science:
- Biomedical Engineering
- Hematology
- Toxicology
Context:
- Developing artificial oxygen carriers is crucial for transfusion medicine.
- Hemoglobin-based oxygen carriers (HBOCs) have been explored for over 100 years.
- Significant challenges have hindered clinical translation of HBOCs.
Purpose:
- To review the historical challenges and recent advancements in developing hemoglobin-based oxygen carriers (HBOCs).
- To discuss modifications that overcome limitations like oxygen affinity, stability, and concentration.
- To highlight ongoing safety evaluations and potential clinical applications of HBOCs.
Summary:
- Four key problems (oxygen affinity, renal/capillary loss, low concentration, toxicity) have historically limited HBOCs.
- Modifications including pyridoxylation, cross-linking, polymerization, and encapsulation have addressed these issues.
- While efficacy is largely established, safety concerns (renal toxicity, NO interactions, antigenicity) remain under investigation.
Impact:
- HBOCs show promise for fluid resuscitation, anemia/ischemia treatment, and organ preservation.
- Clinical trials are underway in the US based on successful animal studies.
- Continued research and development are expected to yield clinically available HBOCs soon.