Artificial Oxygen Carriers Save Lives in Expanded Access Use: Three Cases when Blood Was Not an Option
Zhen W. Mei, Jay S. Raval, Justin Arnall, Sophia H. Hwang, Karen Rodberg, Doris Quon, Dawn C. Ward, Alyssa Ziman, Andrea M. McGonigle, Jonathan S. JahrClinical 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.