Scientists are investigating the production of artificial blood amid the lack of blood and the need for safe transfusions.
Millions of people die worldwide each year due to lack of access to blood, as indicated by the World Health Organization (WHO).
Blood, among many other important functions, carries oxygen throughout the body and removes waste.
In the first clinical trial in 2022, blood grown in the laboratory was used in humans, particularly in patients with rare blood groups.
Scientists are also working on the development of synthetic blood as part of their efforts to support emergency medicine, surgery and blood transfusions.
So how close is scientists to developing artificial blood?
What is artificial blood?
Artificial blood is a broad term that includes both laboratory growth and synthetic blood.
Synthetic blood, which is still being studied, is a completely artificial alternative and does not contain human cells. These engineered molecules mimic the function of blood cells by transporting oxygen. It is primarily designed for emergency use or military medicine, requiring immediate oxygen delivery, but blood type matching is difficult.
For example, the US military invested $46 million in the development of erythromer, a synthetic blood substitute designed to be universally compatible and stable without freezing. This product is still undergoing research and testing to establish its safety and efficacy.
Meanwhile, blood grown in the lab is produced by cultivating human red blood cells in a controlled environment outside the body.
Cedric Gebert, a professor of blood transfusion medicine at the University of Cambridge in the UK, said it could make treatment of available medical cases more effective. For example, lab-grown platelets may be better at stopping bleeding in trauma patients compared to patients given to leukemia patients who were given platelets to prevent bleeding rather than stopping active bleeding.
How is blood grown in the lab produced?
This process begins with stem cells, special cells that can develop into different types of cells in the body. They include red blood cells, platelets (which help clot blood), or even skin cells, depending on where the stem cells are and how they are stimulated.
Scientists use certain types of cells called hematopoietic stem cells to produce all types of blood cells, including white blood cells, red blood cells and platelets. They are found in the bone marrow, the soft tissue within the bone, or in the blood of the donor.
To convert these stem cells into red blood cells, they are placed in laboratory settings and exposed to growth factors, or natural substances that help the cell develop.
Over the course of several weeks, stem cells gradually turn into mature red blood cells, functioning in the same way as natural blood cells.
Ghevaert explained that scientists can “gene-edit” stem cells to promote blood production and remove blood type markers. This could potentially create blood that can be administered to anyone without having to match a particular blood type.
How close is scientists to producing artificial blood?
Currently, laboratory growth or synthetic blood products are only available during the research and development stage.
In 2022, clinical trials in the UK marked a milestone by transporting laboratory-grown red blood cells to human volunteers to assess safety standards and longevity.
More testing is required before this product is medically approved for commercial use.
Furthermore, lab-grown blood production is now much more expensive than using donated blood.
In 2013, the US government agency, Defense Advanced Research Projects Agency (DARPA), reported the chemical materials needed to produce more than $90,000 in a single unit of lab growth blood costs. Through advances in production methods, this cost has been reduced to less than $5,000 per unit. In comparison, US hospitals paid an average of $215 per unit of red blood cells donated in 2019.
Is artificial blood used in clinical trials?
yes. The 2022 clinical trial in the UK marked the first example of such a procedure.
A small early study in Japan in 2022 tested hemoglobin vesicles, small artificial blood components designed to carry oxygen like real red blood cells. This study examined whether they could be a safe and effective alternative to regular blood transfusions.
The study included 12 healthy male volunteers, ages 20-50, divided into three groups. Each group received a single intravenous injection of hemoglobin vesicles with increased volumes of 10ml, 50ml, and 100ml.
Some participants experienced mild side effects, such as fever and rash, but these issues were resolved quickly. There were no major changes in vital signs, including blood pressure.
How far are we from commercially producing blood?
There are still several obstacles to the commercially manufactured pathway to blood.
These include the issue of how to increase production to meet clinical demand, ensuring the safety and functionality of lab growth or synthetic blood products.
Additionally, regulators such as the US Food and Drug Administration (FDA) and the European Medicines Agency are still deciding whether lab-grown blood should be classified as cell therapy or medicine.
“This is a new type of product for any regulatory authority, meaning we are in unknown territory,” he said.
Can you make artificial blood for a rare blood type?
Yes, lab-grown blood can be adjusted to rare blood types.
Cell-free synthetic blood carries oxygen without the need for specific blood group markers. This can become a universal alternative for blood transfusions and reduce the need for accurate matching.
In addition to the typical ABO and rhesus monkey blood types, scientists have identified 36 other blood type systems, each with unique characteristics.
In total, there are over 600 different antigens with small markers on the surface of red blood cells that help the immune system recognize blood as “safe” or “foreign body.”
Blood types are considered rare if they carry or do not have a common antigen that most people don’t have. This makes it more difficult to find compatible donors for blood transfusions.
The frequency of rare blood types varies between different groups and ethnic groups. This means that some people may have a hard time finding a safer blood match than others.
For example, “Bombay Blood” born in India is a rare subset of the O blood layer. It is most common in India, Iran and parts of Southeast Asia, with a frequency of less than 1 in 10,000 people worldwide.
Can the creation of artificial blood solve the global blood shortage?
Experts say artificial blood can reduce global blood shortages, especially in low- and middle-income countries.
According to the WHO, around 118.5 million blood donations are collected worldwide, with 40% collected in high-income countries and only 16% of the world’s population.
Recent studies also show that approximately 2,000 units of blood are required per 100,000 people, particularly in sub-Saharan Africa, South Asia, and Oceania, to meet global health needs.
In these regions where blood supply is very low, bleeding mortality is significantly higher than in wealthy countries.
Rural communities in low- and middle-income countries are the most heavily attacked, forming a “dean of blood.” This is an area where more than 75% of patients who need a blood transfusion do not have access to the blood.
However, these shortages are primarily due to blood storage and access issues. For example, blood banks are often several hours apart, which forces doctors in these areas to delay or cancel life-saving surgery.
Ghevaert said one of the key benefits of lab-grown blood in times of crisis, such as the pandemic, war, and natural disasters when demand suddenly surges, is its value too.
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