It’s remarkable what blood donations can do for modern day medicine.
Leukemia, Hepatitis, the HIV virus, sickle cell disease. The list goes on for the wide variety of diseases that blood transfusions from donations can treat. Surgical procedures benefit too. Complications such as loss of blood or an inability for existing blood cells to produce enough of the substance can be contained with donated blood.
In short, blood donations can be lifesavers for so many patients.
The problem? Exhaustible demand. Blood donations fell by 40% in 2015. This is made all the more severe by statistics obtained from the NHS Blood and Transplant department suggesting that approximately 6,000 blood donations are required every day to treat patients across England and Wales. Up to 200,000 new donors are needed year on year to satisfy this demand.
In short, something needs to be done that boosts bloodstocks, meet this demand, and therefore save lives.
A potential solution could be available from 2017 onwards concerning the role of artificial, or ‘synthetic’ blood. Biological blood is important in transfusions because of one particular role it has: supplying oxygen to human tissue through the use of red blood cells. As a substitute, artificial red blood cells can replicate how real blood works with this role. These blood substitutes are based on the hemoglobin molecule that binds oxygen molecules in the red blood cells during transportation to areas of the human body.
Artificial blood is made from stem cells extracted from a variety of sources. Early templates have used stem cells extracted from umbilical cord blood of newborn babies, the blood of adult donors, and hematopoietic stem cells from volunteered bone marrow, which gives rise to red blood cells inside the marrow. The nutrients and growth factors of stem cells such as these are manipulated in order to produce cells with properties similar to that of red blood cells. For example, throughout their development into fully mature red blood cells, the cell, in preparation for oxygen carrying, forces the nucleus of each cell out.
The development and hopeful administration of this synthetic blood in clinical trials has benefitted from a five-year research programme conducted by scientists from the Universities of Bristol, Cambridge and Oxford. Up until 2017, human volunteers will receive an amount equivalent to a few teaspoons of this artificial blood product in order to test for any adverse reactions that may render the substance harmful to the human body. If successful, the hope is to use this as an alternative to oxygen-carrying red blood and thus satisfy this demand dilemma.
However, generating a supply that meets blood demands is only one benefit in the potential obtainment of a limitless, infection-free synthetic source of blood. Heavy regulation regarding its production means artificial blood has a substantially decreased risk of transmitting infection. In addition, various issues concerning the storage of human blood do not apply for artificial blood. Human blood must be refrigerated until use, with a ‘shelf life’ of about 42 days for human red blood cells.
While there are techniques that can prolong its usefulness, such as cryopreservation, these techniques are rare as they are not cost effective. Instead, synthetic blood can be stored at room temperature, and preservation dates are extended. Because of this, blood banks could potentially keep hold of large stocks of synthetic blood.
Because of its properties, artificial blood also has the potential to be a solution to the issue of blood types. Blood cells have different types of markers that allow for the body to identify them as blood cells which belong to or are needed in their human systems. So somebody who needs Type A human blood (A markers) cannot accept somebody with Type B human blood, and somebody with Type O blood (no markers) can only receive Type O blood donations. Preferred donations concern type O- blood; known as the ‘universal’ type, which has no markers and does not set off any immune responses in a body which would reject the blood and produce health complications. This universal-blood-type debacle may not apply to artificial blood; as these will be similar to type O.
What about the concerns of artificial blood? Production feasibility remains the major concern. For this technique to be successful, these synthetic blood cells would have to be made in their trillions. For example, Giarrantana et al. (2011) were only able to produce 2 milliliters of artificial blood from 10 billion artificial cells. Estimated costs still remain unknown, but the major concern is whether the technology can be scaled to produce enough artificial blood for regular transfusion.
In addition, controversy persists regarding the use of stem cells in producing this substitute. Setbacks could be endured as the stem cell controversy may not make it past certain stakeholders within the artificial blood industry; notably religious groups against abortions or against using blood substitutes ahead of true blood.
Another major issue remains with reducing the role of blood in humans to that of oxygen-carriers; the sole purpose of artificially rendered blood. Controversial accounts exist comparing artificial blood sources against real blood sources concerning oxygen capacity; as comparing the two with an accurate method is very difficult. Clinical trials for an early blood alternative known as HemAssist were terminated; as patients given the alternative died more often than those who received donated blood due to increased artery pressure.This story reflects the dangers of a rapidly progressing area of research. We might not fully appreciate the properties of artificial blood, and this must be taken with caution.
However, the results of these UK clinical trials could determine whether artificial blood remains a major solution to blood donation demands worldwide. Successful application could reduce the burden of blood banks in their supplies to the medical industry not just in the UK but also worldwide, and solve what could possibly be seen as a major health epidemic. Until this can be determined, more must be done to promote the importance of human blood donations and the importance blood has in human life, as we know.
If you would like more information concerning the importance of blood donations, or even to look into donating blood, visit https://www.blood.co.uk