HbXL99a: A hemoglobin derivative that is cross-linked between the a subunits is useful as a blood substitute ( Communicated by Irving M. Klotz, June 11, 1987 (receivedfor review March 11, 1987 ABSTRACT Under deoxygenated conditions, bis(3,5-dibromosalicyl) fumarate reacts with hemoglobin selectively to cross-link the a subunits between Lys-a,99 and Lys-a299. We have characterized further the properties of this recently described hemoglobin and have demonstrated its utility as a blood substitute. The oxygen transport characteristics of the cross-linked derivative are very similar to those of whole blood. Under physiological conditions, the partial pressure of oxygen at half-saturation of hemoglobin is increased to 29 mm Hg (1 mm Hg = 133.3 kPa), compared to 12 mm Hg for hemoglobin A, fully compensating for the absence of 2,3-bisphosphoglycerate outside of the erythrocyte. The Hill coefficient is 2.9. The dependence of the oxygen affinity of HbXL99a on CO2 is also identical to that of hemoglobin A. The cross-link between the a subunits blocks dissociation of oxyhemoglobin into a4 dimers and thereby prevents renal excretion of the modified hemoglobin. In the rat, the half-life of HbXL99a in plasma, at a 15% volume exchange, is increased to 3.3 hr, compared to 90 min for hemoglobin A. Cross-linking HbXL99a intermolecularly with bis(sulfosuccinimidyl) suberate to form predominantly a mixture of dimers and trimers further increased the half-life of the hemoglobin within the circulation by about 2-fold. The rate of autooxidation of the transfused hemoglobin was found to be markedly reduced because of the presence of an endogenous reducing system in plasma.