人工氧载体在扩大使用范围中挽救生命：三例无法使用血液的情况。

Artificial Oxygen Carriers Save Lives in Expanded Access Use: Three Cases when Blood Was Not an Option.

作者信息

Mei Zhen W, Raval Jay S, Arnall Justin, Hwang Sophia H, Rodberg Karen, Quon Doris, Ward Dawn C, Ziman Alyssa, McGonigle Andrea M, Jahr Jonathan S

机构信息

Transfusion Medicine, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Transfusion Medicine and Therapeutic Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM.

出版信息

Am J Ther. 2025;32(1):e30-e34. doi: 10.1097/MJT.0000000000001777.

DOI:10.1097/MJT.0000000000001777

PMID:39764843

Abstract

CLINICAL 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.

摘要

临床特征

镰状细胞病患者可能产生多种抗体，并在输血时经历危及生命的事件，如高溶血综合征或迟发性溶血性输血反应。在这种情况下，可能无法进行进一步输血。

治疗挑战

当没有常规血液制品可供输血，但患者需要额外的携氧支持时，可能需要人工氧载体。然而，目前尚无美国食品药品监督管理局（FDA）批准的此类产品。

解决方案

已完成针对一种基于聚合血红蛋白的氧载体（HBOC - 201，Hemopure）的紧急研究性新药申请，并批准这些患者扩大使用。HBOC - 201是一种基于牛血红蛋白的研究性氧载体。在此，我们报告了在等待支持性治疗、促红细胞生成素和/或免疫调节药物起效的过程中，HBOC - 201的急性复苏如何在所有3例患者中潜在地挽救了生命。