{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:07:55Z","timestamp":1783688875586,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,10,26]],"date-time":"2017-10-26T00:00:00Z","timestamp":1508976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Red blood cell (RBC) transfusion is an important treatment modality during severe sickle cell crisis (SCC). SCC patients who refuse, or cannot accept, RBCs present a unique challenge. Acellular hemoglobin (Hb)\u2010based oxygen carriers (HBOCs) might be an alternative for critically ill patients in SCC with multiorgan failure due to life\u2010threatening anemia. HBOC\u2010201 (HbO2 Therapeutics) has been administered to more than 800 anemic patients in 22 clinical trials, but use of any HBOCs in critically ill sickle cell patients with organ failure is exceedingly rare. In the United States, HBOC\u2010201 is currently only available for expanded access.<\/jats:p><\/jats:sec><jats:sec><jats:title>CASE REPORT<\/jats:title><jats:p>We report three cases of HBOC\u2010201 administered to critically ill sickle cell disease patients in SCC with multiorgan failure, either who refused RBCs (Jehovah's Witnesses) or for whom compatible RBCs were not available.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Two patients received more than 20 units of HBOC\u2010201, while the other received 6. The 27 units used in the third case equals the largest volume a patient has successfully received to date. All three patients survived to hospital discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>These reports suggest that blood substitutes such as HBOC\u2010201 can provide an oxygen bridge in SCC with multiorgan failure, until corpuscular Hb levels recover to meet metabolic demand, and highlight the compelling biochemical properties that warrant further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14386","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T04:12:38Z","timestamp":1509077558000},"page":"132-137","source":"Crossref","is-referenced-by-count":31,"title":["Use of the blood substitute HBOC\u2010201 in critically ill patients during sickle crisis: a three\u2010case series"],"prefix":"10.1111","volume":"58","author":[{"given":"Jonathan M.","family":"Davis","sequence":"first","affiliation":[{"name":"Baystate Medical Center, Tufts University School of Medicine Springfield Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nura","family":"El\u2010Haj","sequence":"additional","affiliation":[{"name":"Baystate Medical Center, Tufts University School of Medicine Springfield Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimish N.","family":"Shah","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garry","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Levine Cancer Institute, Carolinas Healthcare System Charlotte North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Block","sequence":"additional","affiliation":[{"name":"CHI Health\/Creighton University and Methodist Health System Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Wall","sequence":"additional","affiliation":[{"name":"Levine Cancer Institute, Carolinas Healthcare System Charlotte North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Tidswell","sequence":"additional","affiliation":[{"name":"Baystate Medical Center, Tufts University School of Medicine Springfield Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2465-655X","authenticated-orcid":false,"given":"Ernest","family":"DiNino","sequence":"additional","affiliation":[{"name":"Baystate Medical Center, Tufts University School of Medicine Springfield Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,10,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.10517"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1076029609352661"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318176cc66"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2002.03694.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0958-7578.2004.00502.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom7010002"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1807-59322009000800016"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc2455"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tibtech.2014.02.006"},{"key":"e_1_2_6_11_1","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/978-3-642-40717-8_31","volume-title":"Hemoglobin\u2010based oxygen carriers as red cell substitutes and oxygen therapeutics","author":"Moon\u2010Massat PF","year":"2013"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-012759760-7\/50047-0"},{"key":"e_1_2_6_13_1","first-page":"379","article-title":"Clinical trial of a hemoglobin based blood substitute in patients with sickle cell anemia","volume":"174","author":"Feola M","year":"1992","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2002.00184.x"},{"key":"e_1_2_6_15_1","unstructured":"ShanderA.Expanded access study of HBOC\u2010201 (Hemopure) for the treatment of life\u2010threatening anemia [Internet]. 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