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Hemoglobin substitutes

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Abstract

Orthopaedic patients frequently require blood transfusions to treat peri-operative anemia. Research in the area of hemoglobin substitutes has been of great interest since it holds the promise of reducing the reliance on allogeneic blood transfusions. The three categories of hemoglobin substitutes are (1) cell-free, extracellular hemoglobin preparations made from human or bovine hemoglobin (hemoglobin-based oxygen carriers or HBOCs); (2) fluorine-substituted linear or cyclic carbon chains with a high oxygen-carrying capacity (perfluorocarbons); and (3) liposome-encapsulated hemoglobin. Of the three, HBOCs have been the most extensively studied and tested in preclinical and clinical trials that have shown success in diminishing the number of blood transfusions as well as an overall favorable side-effect profile. This has been demonstrated in vascular, cardiothoracic, and orthopaedic patients. HBOC-201, which is a preparation of cell-free bovine hemoglobin, has been approved for clinical use in South Africa. These products may well become an important tool for physicians treating peri-operative anemia in orthopaedic patients.

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Acknowledgments

Dr. MacKenzie would like to acknowledge that he is a consultant as well as a site principal investigator for the Biopure Corporation.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, PA, 19104, USA

    Kevin K. Anbari & Jonathan P. Garino

  2. Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD , 21201, USA

    Colin F. Mackenzie

  3. Department of Orthopaedic Surgery, 1 Cupp Pavilion, Presbyterian Hospital, 39th and Market Streets, Philadelphia, PA, 19104, USA

    Jonathan P. Garino

Authors
  1. Kevin K. Anbari
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  2. Jonathan P. Garino
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  3. Colin F. Mackenzie
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Correspondence to Jonathan P. Garino.

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Anbari, K.K., Garino, J.P. & Mackenzie, C.F. Hemoglobin substitutes. Eur Spine J 13 (Suppl 1), S76–S82 (2004). https://doi.org/10.1007/s00586-004-0737-x

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  • DOI: https://doi.org/10.1007/s00586-004-0737-x

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