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Hemoglobin substitutes

  • Kevin K. Anbari
  • Jonathan P. Garino
  • Colin F. Mackenzie

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) fluorinesubstituted 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 cellfree 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.

Keywords

Hemoglobin substitute HBOC HBOC-201 Perfluorocarbons 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2005

Authors and Affiliations

  • Kevin K. Anbari
    • 1
  • Jonathan P. Garino
    • 1
    • 2
  • Colin F. Mackenzie
    • 3
  1. 1.Department of Orthopaedic SurgeryUniversity of Pennsylvania Health SystemPhiladelphiaUSA
  2. 2.Department of Orthopaedic Surgery, 1 Cupp PavilionPresbyterian HospitalPhiladelphiaUSA
  3. 3.Department of AnesthesiologyUniversity of Maryland School of MedicineBaltimoreUSA

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