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Hemoglobin glutamer-250 (bovine), commonly known by the trade name Hemopure (HBOC-201), is a glutaraldehyde-polymerized bovine hemoglobin-based oxygen carrier (HBOC) [1, 2]. It is designed as a therapeutic blood substitute to provide immediate tissue oxygenation in clinical scenarios such as acute surgical anemia or hemorrhagic shock, particularly when allogeneic red blood cell transfusion is unavailable or contraindicated [3, 8]. The molecule consists of purified bovine hemoglobin tetramers that are cross-linked into polymers with an average molecular weight of 250 kDa, a modification that increases its intravascular half-life and reduces the renal toxicity typically associated with stroma-free hemoglobin [1, 11]. Despite its efficacy in oxygen transport, Hemopure has been associated with significant safety concerns, most notably systemic hypertension and vasoconstriction resulting from the scavenging of endogenous nitric oxide by cell-free hemoglobin [4, 8]. While it has received regulatory approval for human use in South Africa and veterinary use in the United States and Europe, its development in other regions has been limited by these therapeutic challenges [1, 10].
Acts as a cell-free oxygen carrier that binds oxygen at high partial pressures (e.g., in the lungs) and releases it to tissues at lower partial pressures, bypassing the requirement for red blood cells.
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