Why do some patients refuse red blood cells (RBC) but accept HBOCs?
• Although HBOCs function and behave similarly to RBCs in their oxygen carrying capacity, they do not eliminate carbon dioxide as do RBCs. Even though it is made from RBCs, the RBCs are broken apart, the hemoglobin is taken out, chemically changed so it isn’t even technically hemoglobin anymore, and then chemically linked into a chain of molecules that can carry oxygen to tissues like blood does. Blood delivers O2 and disposes of CO2, whereas PolyHeme® does deliver O2 but can’t take the CO2 out of cells like blood does, so it isn’t really exactly like the primary component of RBCs, or blood itself. The part of the primary component (RBCs) used is only a fraction, and the remainder of the blood (whole red cells, plasma, white blood cells, and platelets) is not used. It is not really one of the four primary components any longer. • HBOC is no longer considered a hemoglobin molecule because it has been stripped of its DNA.
