Saturday May 19, 2007
Blood substitutes

Though blood substitutes are not yet approved in USA but are now in use in other parts of the world. In this regard 2 products are worth mentioning.

1. Hemopure : is a Bovine derived blood substitute and has already been approved for use in adult patients in South Africa.

2. Polyheme: is a human derived blood substitute and Phase III trial in united states completed in July 2006 1 for its role in for hemorrhagic shock following traumatic injuries. But there are unconfirmed media reports of increase coronary events in study 5.

Blood substitutes are solutions of chemically modified human or bovine hemoglobin which restores lost blood volume and can be given as rapid, massive infusion. One unit is equal to one unit of pRBC and can be given wide open.

Advantages: Does not require typing or cross-matching before infusion and so far found not to cause transfusion reactions. Shelf life of over 12 months (ciruclation time is 1-2 days) and does not require refrigeration. Bovine based Hemopure has been said acceptable for use in Jehovah's Witnesses (?).

Disadvantages: No evidence based data available yet. Concerns raised regarding mad cow disease in bovine based Hemopure !


References: Click to get abstract/article

1. Safety and Efficacy of PolyHeme(R) in Hemorrhagic Shock Following Traumatic Injuries Beginning in the Pre-Hospital Setting - clinicaltrials.gov
2. Watchtower Approves HemoPure for Jehovah's Witnesses - ajwrb.org
3. Effect of Hemopure® on Prothrombin Time and Activated Partial Thromboplastin Time on Seven Coagulation Analyzers, - Clinical Chemistry. 1997;43:1792
4. PolyHeme - American College of Surgeons at facs.org
5. PolyHeme Lawsuit - polyhemelawsuit.com