Hemoglobin also carries the important regulatory molecule nitric oxide bound to a globin protein thiol group, releasing it at the same time as oxygen. Haemoglobin is also found outside red blood cells and their progenitor lines. Other cells that contain haemoglobin include the A9 dopaminergic neurons in the substantia nigra, macrophages, alveolar cells, lungs, retinal pigment epithelium, hepatocytes, mesangial cells in the kidney, endometrial cells, cervical cells and vaginal epithelial cells. In these tissues, haemoglobin has a non-oxygen-carrying function as an antioxidant and a regulator of iron metabolism. Haemoglobin and haemoglobin-like molecules are also found in many invertebrates, fungi, and plants.
Packed red blood cells used to restore oxygen-carrying capacity in people with anemia due to trauma or other medical problems, and are by far the most common blood component used in transfusion medicine. Historically they were transfused as part of whole blood, but are now typically used separately as RBCs and plasma components. The process of identifying a compatible blood product for transfusion is complicated. Side effects can include allergic reactions including anaphylaxis, red blood cell breakdown, fluid overload, infection, and lung injury. Giving incompatible RBCs to a person can be fatal. With current testing methods in high-income countries the risk of infection is