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Despite strategies to conserve use of packed red blood cells (PRBCs), experts predict that availability will not meet the increasing demand by an aging population. Hemoglobin-based oxygen carrier-201 (HBOC-201) is a bovine–hemoglobin-based blood substitute that is approved in South Africa for clinical use. In a randomized, single-blind, controlled, multinational study, researchers (some of whom were affiliated with the manufacturer) assessed whether administration of HBOC-201 eliminates the need for PRBC transfusion in adult patients undergoing orthopedic surgery.
Overall, 688 patients (mean age, 61) with hemoglobin concentrations <10.5 g/dL who required transfusions were randomized to treatment with HBOC-201 or PRBCs. Once treatment was ini…