In the Future, We Could Make Human Blood in Factories

After all the regenerative medicine excitement last week with the creation of lab-grown vaginas and nostrils, scientists in the UK have their sights set on something a little less niche: blood.

In the past year, a team of researchers have managed to create red blood cells from pluripotent cells—stem cells that can be formed into any kind of cell—and now they’ve been awarded a grant from the Wellcome Trust to trial the cells in humans for the first time. The first three volunteers will receive some of the lab-cultured red blood cells before the end of 2016, and the goal is to eventually go mainstream. Think full-scale "blood factories," according to the Telegraph.

I spoke to Jo Mountford, one of the scientists working on producing the cells at the University of Glasgow who also works with the Scottish National Blood Transfusion Service. She explained that their aim had been to create red blood cells that were “the closest thing possible to a red cell you would take from a donor,” but made in a dish rather than taken from someone’s arm.

Getting those cells into a human, however, presents a few more challenges. “One of the challenges is cell numbers,” she said. “There’s between one and two trillion red cells in a single unit of blood—that’s 12 zeroes—and those cell numbers are difficult to grow in the lab, so we’re looking at ways to scale up and bioreactor technologies to do that.”

Then there’s the quality control that comes with human trials, which mean the whole process has to go through appropriate protocols. At the moment, they’re comparing their lab-grown cells to natural human blood cells to check that they’re as similar as possible.

The aim is to scale up the process so it’s possible to manage on a commercial scale. I was intrigued by what exactly the commercial market for human blood was, and it turns out it’s quite different depending on where in the world you are. Mountford explained that in the UK, where the National Health Service (NHS) runs blood services, the headline price of a bag of blood is around £120 ($200), though that doesn’t incorporate the costs of providing the services, getting the donors, and so on. It’s perhaps not strictly what you'd think of as “commercial,” but it’s a market with big demands.

And in other countries, altruistic donor services like that don’t exist. In some places, Mountford said, you (or your family) have to replace units of blood used. We’re a way off, but one idea is that the UK could potentially provide for these markets too.

Then there are more niche requirements, such as patients with certain conditions like the inherited blood disorder Thalassaemia, who need regular transfusions. Engineering blood cells from stem cells could allow scientists to make a more effective product that could be transfused less regularly or combat the side-effect of iron overload in these patients.

Of course, for lab blood cells to really offer an alternative to the donated red stuff, it’ll have to be cost-effective, which, right now, it’s not. “At the moment no, the first unit will cost pretty much what the grant funding that’s gone into it is,” said Mountford. But after they’ve figured out how to scale up the process, it’ll get cheaper.

The advantages of that kind of scaled-up system of lab-produced blood is obvious: you wouldn’t have supply shortages, and you wouldn’t have to worry about infections being transferred from the donor, as has happened in the past with hepatitis, HIV, and vCJD (mad cow disease). That risk is currently managed, but it can’t be totally eradicated. “We don’t know what the next emerging pathogen will be, so we can’t screen for it,” said Mountford.

It all adds up to the rather compelling (and vampiric-sounding) idea of blood factories. If you’re imagining great vats of blood simmering away, you’re probably actually pretty close. They’re still a thing of the future right now, but Mountford said a blood factory would be similar to the large pharmaceutical factories producing protein therapeutics.

“It would be in very big metal bioreactor tanks of thousands of litres in a batch,” she said, then left me with an image that got my inner sci-fi nerd very excited: “I suppose the closest normal-world analogy is it would look a little like an oil refinery or a brewery.”