title: Hemoglobin glutamer-250 (bovine) in South Africa: consensus usage guidelines from clinician experts who have treated patients.
abstract: Hemopure (hemoglobin glutamer-250 [bovine]; HBOC-201) is a hemoglobin (Hb)-based oxygen carrier registered with the Medicines Control Council of South Africa. It is indicated for the treatment of adult patients who are acutely anemic, for the purpose of maintaining tissue oxygen delivery thus eliminating, delaying, or reducing the need for allogeneic red blood cells (RBCs). Hemopure is a volume expander, and circulatory volume must be carefully monitored for signs of fluid overload. Hemopure is not as effective as RBCs for restoring Hb content and concentration, but in cases of severe anemia where allogeneic blood is not an option or is unavailable, it may offer an immediate alternative for improving oxygen transport. This document provides clinical recommendations on the safe and effective use of Hemopure based on the postmarketing experience in South Africa as well as a better understanding of Hemopure properties reflected in recent publications.
authors.affiliation: Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand, Gauteng, South Africa.
authors.forename: Mervyn
authors.initials: M
authors.lastname: Mer
authors.affiliation: Nkosi Albert Luthuli Hospital, Nelson R. Mandela School of Medicine, Durban, South Africa.
authors.forename: Eric
authors.initials: E
authors.lastname: Hodgson
authors.affiliation: University of Cape Town, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Lee
authors.initials: L
authors.lastname: Wallis
authors.affiliation: National Health Laboratory Service, Johannesburg Hospital, Johannesburg, South Africa.
authors.forename: Barry
authors.initials: B
authors.lastname: Jacobson
authors.affiliation: Sunninghill Hospital, Gauteng, South Africa.
authors.forename: Lewis
authors.initials: L
authors.lastname: Levien
authors.affiliation: Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.
authors.forename: Jacques
authors.initials: J
authors.lastname: Snyman
authors.affiliation: Milpark Hospital, Gauteng, South Africa.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Sussman
authors.affiliation: Department of Anesthesia, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Mike
authors.initials: M
authors.lastname: James
authors.affiliation: Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.
authors.forename: Antoine
authors.initials: A
authors.lastname: van Gelder
authors.affiliation: Division of Emergency Medicine, University of Cape Town and Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Rachel
authors.initials: R
authors.lastname: Allgaier
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California. jsjahr@mednet.ucla.edu.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Jahr
mesh_terms: D000818:Animals; D001802:Blood Substitutes / Q000627:therapeutic use; D002417:Cattle; D032921:Consensus; D017707:Erythrocyte Transfusion / Q000379:methods; D006454:Hemoglobins / Q000627:therapeutic use*; D006801:Humans; D010100:Oxygen / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011358:Product Surveillance, Postmarketing; D013019:South Africa
chemical_list: D001802:Blood Substitutes; D006454:Hemoglobins; C096798:HBOC 201; D010100:Oxygen