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Sept 22, 1969

The Expanding Universal Expander

JAMA. 1969;209(12):1899-1900. doi:10.1001/jama.1969.03160250055015

The expanding need for the plasma expander at one time promised to be met by expanded stores of proteins in human plasma. When serum hepatitis interfered, the therapeutist lost a precious friend. Storage of plasma will preserve most of its properties, while lessening somewhat the risk of transmission of hepatitis, but not to the point of elimination.

The dream of the perfect expander has yet to come true. Purified plasma proteins, albumin preparations, and large molecule dextrans all have their places, but meanwhile search has suggested hemoglobin solutions as possible servants.

A hemoglobin solution would have the ideal osmotic activity, with its molecular weight of approximately 68,000; it can transport and exchange oxygen and does not require typing or crossmatching. Risk of renal damage or of decay into methemoglobin needs to be eliminated, but preparation (in experimentally small quantities, to be sure) has been effected of a hemoglobin solution free