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2022, Number 2

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Rev Hematol Mex 2022; 23 (2)

HBOC-201 as alternative to blood transfusions in a patient with Rh- Bombay phenotype

Novo-González P, Rodríguez-Fernández M, García-Lázaro S, Hidalgo-Correas FJ, Berberana-Fernández de Murias M

Language: Spanish
References: 17
Page: 111-119
PDF size: 311.63 Kb.


ABSTRACT

Background: The Bombay phenotype is one of the most unusual blood groups in the ABO system. These individuals are characterized by antibodies against all blood groups, so they can only receive transfusions from themselves or from other patients of the same phenotype.
Clinical case: A patient with a Bombay phenotype who was also Rh-, which made it even more difficult to obtain compatible blood. The patient developed severe anemia leading to the consumption of all available compatible blood bags. As a consequence of the low incidence of Bombay Rh- phenotype in Europe, compatible blood bags were requested from Australia and Canada. Bureaucratic problems caused these bags to take too long while the patient continued to get worse. In view of this severe and unique situation, the Spanish Agency for Medicine and Health Products authorized, through a program for medicines in special conditions, the acquisition of HBOC-201 (Hemopure®), an oxygen carrier based on blood cell-free hemoglobin derived from bovine blood. HBOC-201 succeeded in maintaining hemoglobin levels and prolonging the patient’s life until bags of compatible blood arrived. Nevertheless, the patient evolved torpidly, with significant thrombosis of the distal upper limbs and its exitus.
Conclusions: Being Bombay Rh negative with allo-antiD makes it difficult to obtain worldwide. This circumstance originates the delay in its administration, for which it is necessary to propose other alternatives.


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