Hemoglobin Agent Can Replace Transfusion During Surgery

A study has shown that an agent made of purified human hemoglobin appears safe and may be effective when used instead of transfused human blood to replace blood lost during heart surgery.

It is important to develop an effective oxygen therapeutic not only because of the decreasing donor pool for human blood and fears of disease transmission, but also because transfused blood may lead to worse outcomes after heart surgery, according to Steven Hill, M.D., an anesthesiologist at Duke University Medical Center (Durham, NC, USAA recent study showed that five years after heart surgery, 15% of patients who received blood transfusions had died, compared to 7% of those who did not have a transfusion.

The agent used in the new study, known as hemoglobin raffimer, produced elevated blood pressures during surgery but it was manageable and was the only significant side effect. The raffimer is produced by removing hemoglobin from human red blood cells whose shelf life has expired. The extracted hemoglobin is heat-treated and filtered, which eliminates risks of infectious agents. During cardiac surgery, a hemoglobin-based oxygen carrier would provide additional circulating hemoglobin to facilitate safe removal of the patient's own blood and support oxygen delivery to the body during the three or four hours of surgery.

In the study, 60 patients undergoing coronary artery bypass surgery were randomized to receive either varying doses of hemoglobin raffimer or a colloid solution during surgery. Of those receiving hemoglobin raffimer, 44% did not need a blood transfusion, while only 18% of the control group avoided a transfusion. "If we had an agent that could temporarily sustain oxygen delivery to the body during surgery without having to use donated blood, that could have significant long-term potential for our patients,” said Dr. Hill.




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Duke Univ. Med. Ctr