The Las Vegas shooting is the latest reminder that human blood isn't enough for massive, unexpected transfusions.
United Blood Services phlebotomist Sha-Na Hill (L) takes blood from Richard Williams of Nevada at a special United Blood Services drive at a University Medical Center facility to help victims of a mass shooting on October 2, 2017 in Las Vegas, Nevada. Image: Ethan Miller/Getty Images
In the aftermath of the Las Vegas mass shooting on Sunday, hundreds of people lined up to give blood at a handful of donation centers in the area. It was a heartening scene—people hoping to help in any way they could. But if science lives out its promise, it will one day be an obsolete one.
Scientists have been working on creating synthetic blood for years now. The hope is that this substance will have a longer shelf life than human blood—which can only be refrigerated for 42 days—and eventually can be packaged and stored for use in emergencies. If this works, thousands of lives could be saved every year.
"People can't show up fast enough and then the system can't draw their blood fast enough to meet the need," said Allan Doctor, a physician and researcher at the Washington University in St. Louis. "Pulse nightclub, Boston Marathon, now Vegas—all of these are situations where there's a sudden unpredictable need for massive transfusion."
Doctor's lab has been working to create a blood substitute called ErythroMer, comprised of human hemoglobin, sourced from the red blood cells in expired blood at blood banks, and a synthetic polymer. This synthetic blood is actually a dehydrated powder, which would allow it to be stored for years, rather than weeks, and easily transported. Doctor envisions that it could eventually be packaged along with purified water so that doctors or EMTs could mix it when they needed to use it on a patient.
ErythroMer is still in the planning stages. It has only been tested on animals, and Doctor predicts that the team is about three to five years from the first human trials. Following that, it will need FDA approval, and then healthcare workers will need to be trained to use it properly to avoid infections. "It's important for us to have a bulletproof delivery system," Doctor told me. He predicts that it will be available in six to 10 years if the trials are successful, and if they can make a cost-effective formula.
There are different approaches to creating synthetic blood, which is technically just a way of transporting oxygen in the body. In 2013, a team in Romania announced that they were making it with albumin, a liver protein, and hemerythrin, a protein extracted from worms. In the UK, scientists with the National Health Service have been testing lab-grown red blood cells.
"It's important for us to have a bulletproof delivery system"
The results could change the way we practice medicine, and how first responders treat victims. In the aftermath of the Vegas massacre, where at least 58 people were killed and hundreds injured, the scenes reported from the hospitals was gruesome, with blood-soaked hallways, and trauma centers running out of supplies. Even outside of extreme situations, Doctor said 20,000 people in the US die every year because they don't receive blood on time, and 70 percent of our military casualties are caused by bleeding to death.
The US is no stranger to blood shortages—in September of this year, the Red Cross called for donations because their stores were critically low, and some elective surgeries were cancelled. Donors are helpful, but not consistent. And synthetic blood could also limit the risk of infections, or immune system responses to foreign blood. While Doctor's team is considering the use of non-human hemoglobin, he said there are enough red blood cells available at blood banks right now to sustain ErythroMer for years.
As scientists work to bring their synthetic blood to the masses, Americans are not necessarily on board. My colleague Sarah Emerson reported last year that 63 percent of the 4,700 adults in a Pew Research Survey don't like the idea of synthetic blood, citing distrust.
Regardless, the idea that this kind of invention could have saved even some of the people lost in the Vegas shooting can't be ignored. And with other parts of the world, like Sub-Saharan Africa, face a far more critical shortage of blood supplies on a daily basis. That should be enough to convince the skeptics that this is a worthwhile endeavor.
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