title: Effect of the hemoglobin-based oxygen carrier HBOC-201 on laboratory instrumentation: cobas integra, chiron blood gas analyzer 840, Sysmex SE-9000 and BCT.
abstract: As part of a clinical trial, we evaluated the effects of the hemoglobin-based oxygen-carrier (HBOC) HBOC-201 (an ultrapurified, stroma-free bovine hemoglobin product, Biopure, Cambridge, MA, USA) on our routine clinical chemistry analyzer (Cobas Integra, F. Hoffmann-La Roche Ltd, Basel, Switzerland ), blood gas analyzer (Chiron 840, Chiron Diagnostics Corporation, East Walpole, MA, USA), routine hemocytometry analyzer (Sysmex SE-9000, TOA Medical Electronics Co Ltd., Kobe, Japan), hemostasis analyzer (BCT, Dade-Behring, Marburg, Germany) and bloodbanking system (Dia-Med-ID Micro Typing System, DiaMed AG, Cressier, Switzerland). The maximum tested concentration of HBOC-201 was 65 g/l. Of the 27 routine clinical chemistry tests challenged with HBOC-201, bilirubin-direct, creatine kinase MB-fraction (CK-MB), creatine kinase (CK), gamma-glutamyltransferase (GGT), magnesium and uric acid were influenced by even low concentrations of HBOC-201. These tests were excluded from use on the plasma of patients treated with HBOC-201. Since the non-availability of the cardiac marker CK-MB may lead to problems in acute situations, we introduced the qualitative Trop T-test (Boehringer Mannheim), which was not influenced. The applicability of another nine tests was limited by the concentration of the HBOC-201 in the patients' plasma. No interference of HBOC-201 in routine hemocytometry, hemostasis-analysis and red-blood cell agglutination detection (blood-bank tests) was observed. Although immediate patient-care was not compromised, routine use of hemoglobin-based oxygen carriers will have a strong impact on logistical management. The development of robust laboratory tests free from the interference of the pigmented oxygen carriers should therefore precede its introduction into routine transfusion medicine.
authors: Laboratory for Clinical Chemistry and Hematology, Atrium Medisch Centrum Heerlen, The Netherlands. alwo@dds.nl
authors: A
authors: A
authors: Wolthuis
authors: D
authors: D
authors: Peek
authors: R
authors: R
authors: Scholten
authors: P
authors: P
authors: Moreira
authors: M
authors: M
authors: Gawryl
authors: T
authors: T
authors: Clark
authors: L
authors: L
authors: Westerhuis
mesh_terms: D001784:Blood Gas Analysis / Q000295:instrumentation*; D001802:Blood Substitutes; D003627:Data Interpretation, Statistical; D006454:Hemoglobins; D006801:Humans; D007202:Indicators and Reagents
chemical_list: D001802:Blood Substitutes; D006454:Hemoglobins; D007202:Indicators and Reagents; C096798:HBOC 201