Morphological effects of transfusions with hemoglobin solutions.
The current investigation describes the morphological and pathophysiological effects of stroma-free hemoglobin solution (SFH) on the liver and kidney. One h after a 75% blood volume exchange in animals receiving 7% SFH, hepatic morphology was normal. Animals whose blood was similarly exchanged with 7% albumin demonstrated evidence of cellular hypoxia. These findings suggested that SFH initially transported and offloaded sufficient oxygen to prevent hypoxic alterations. Twelve and 24 h after exchange with albumin, the livers were normal, whereas those of SFH-transfused rats exhibited centrolobular necrosis. Studies of intravascular volume, free circulating hemoglobin distribution, and urinary volumes revealed that the hemoglobin tetramer was degraded rapidly into monomers which traversed the glomerular basement membrane, causing a diuresis. The latter resulted in a 40% loss of intravascular volume, 6 h after SFH administration. When intravascular volume and hemoglobin concentration were maintained by bolus infusions of SFH, hepatic necrosis did not occur. Free hemoglobin was incorporated into the cytoplasm of proximal renal tubular cells and also appeared in the lumens of the distal tubules. However, 24 h after exchange transfusion, almost all of the hemoglobin had left the kidneys and there was no morphological evidence of renal dysfunction. Serum creatinines were normal after SFH administration. The slight rise in BUN was attributed to the dehydration caused by hemoglobin diuresis.
D000418:Albumins / Q000494:pharmacology; D000818:Animals; D001802:Blood Substitutes / Q000494:pharmacology*; D006454:Hemoglobins / Q000494:pharmacology*; D007668:Kidney / Q000187:drug effects* / Q000648:ultrastructure; D008099:Liver / Q000187:drug effects* / Q000648:ultrastructure; D008297:Male; D010100:Oxygen / Q000378:metabolism; D051381:Rats
D000418:Albumins; D001802:Blood Substitutes; D006454:Hemoglobins; C016484:hemoglobin, stroma free; D010100:Oxygen