BloodSubstitutes

BloodSubstitutes - Blood substitutes Artificial blood...

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www.chemistryworld.org 40 | Chemistry World | October 2010 Blood substitutes Human blood substitutes have been in the pipeline since the 1980s. But, for a combination of scientific and political reasons, there are none currently on the market in either Europe or the US. There are a few blood substitutes still progressing through clinical trials, and the academic community is still actively improving the products, also known as oxygen therapeutics and haemoglobin-based oxygen carriers. ‘No one was interested in this type of work until HIV came in the 1980s,’ explains Thomas Chang from McGill University, Montreal, Canada, an early pioneer of the field, ‘and then everyone started to look into making artificial blood substitutes.’ He adds, ‘we have to be ready for another HIV episode or similar when the blood might be contaminated.’ It was HIV concerns that led to South Africa becoming one of the few countries so far to approve the use of a blood substitute – a product called Hemopure. Fears of contaminated donor blood supplies are just one reason for the interest in this area. Ongoing concerns about lack of donor blood supplies in remote locations are also driving the field forward, with the US army and navy funding much of the research. You never know when there will be a disaster or war when we won’t have sufficient blood reserves, says Chang. More niche needs include patients, such as Jehovah’s Witnesses, who for religious reasons can not use donor blood, and patients who have developed immune responses to donated blood. Aside from not being reliant on donor blood supplies, other major advantages of artificial blood include not needing to check blood types before transfusion – artificial blood is the universal blood group O negative. Artificial blood also avoids shelf life issues – donor blood can be stored for a maximum of 42 days before use, and starts to degrade in quality shortly after collection. Outsmarting obstacles The need and utility may be clear, but the route to regulatory approval in Europe and the US has been tortuous – with numerous hurdles seemingly intent on blocking the way. The first clinical trials for these products – run by a number of different companies – had disappointing results with some unwanted side effects, most seriously an increase in blood pressure. Chang blames the results on a rush to get a product to market in the wake of the HIV crisis: ‘not enough basic research was done prior to HIV – and as a result, when it was realised that donor blood could be contaminated, companies started to make many different types of blood substitutes, and unfortunately some don’t work and some have adverse side effects.’ The concerns came to a head in early 2008, when a meta-analysis of findings from 16 clinical trials of five different products that had been used on over 3500 patients was published in the Journal of the American Medical Association . The study, led by Charles
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BloodSubstitutes - Blood substitutes Artificial blood...

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