What is efficacy of diaspirin cross-linked hemoglobin (DCLHb) as a blood substitute?

Updated: Dec 11, 2018
  • Author: Sara J Grethlein, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Diaspirin cross-linked hemoglobin (DCLHb) is the prototype molecule of this category of blood substitutes. It consists of cross-linking between the two alpha chains that lend stability to the molecule. The cross-linking agent is bis (dibromosalicyl) fumarate (DBBF). DCLHb made from outdated human blood has a shelf life of approximately 9 months when frozen and 24 hours when refrigerated. The intravascular half-life is 2-12 hours and is dose dependant. Clinical trials proved that this compound did indeed raise blood oxygen content. However, it also caused intense vasoconstriction resulting in increased systemic pressure, reduced cardiac output, and increased vascular resistance. Hence, no net benefit was derived from this product.

A great deal of work on DCLHb was initially performed by the US Army. They contracted Baxter Healthcare (Deerfield, Ill) to produce DCLHb (HemAssist) on a large scale. However, due to significant adverse effects associated with it, the army discontinued further development of this molecule. Subsequently, Baxter Healthcare halted further development of DCLHb in 1998 after the product failed trials in patients with stroke and trauma. [7]


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