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The Future of Patient Care? — Stanford Blood Center

By Krista Thomas, Communications Strategist

As amazing and lifesaving as blood is, it’s not a perfect product. First, there’s the issue of shelf-life: Red blood cells can usually only be stored for up to 42 days, after which it should no longer be transfused to patients due to decreased efficacy. Then there’s the issue of needing the right blood type, which may or may not be readily available. And, of course, the biggest issue, blood supply — i.e., whether or not any blood is available at all.

For months now, you’ve likely heard blood centers around the U.S. describing a “blood shortage.” Roughly one in seven hospital patients need blood, which equates to about 30,000 red cell units needed in the U.S. each day. It’s a tall order to fill, and finding enough volunteer donors to meet that need has been and continues to be a real challenge. That’s why, for many years, researchers have salivated at the possibility of creating artificial blood, or “blood substitutes.”

 

The “Ideal” Blood Substitute

An ideal blood substitute is valued based primarily on its ability to transport oxygen throughout the body, though factors such as producibility and shelf-life are also important.

 

Early Attempts

Even before real blood transfusions were popularized, doctors and researchers were interested in finding a substance to replace blood lost in their patients. According to the National Center for Biotechnology Information (NCBI), early attempts at finding substitutes were spurred by William Harvey’s discovery of circulation in 1616. Per NCBI, “In the years to follow, medical practitioners tried numerous substances such as beer, urine, milk, plant resins, and sheep blood as a substitute for blood.”

In fact, milk was a big hit. It was first used as a treatment for Asiatic cholera because it was believed to increase production of white blood cells, which are necessary for building immunity. Transfusion of cow, goat and even human milk became particularly popular in the United States in the 1870s and 1880s, though its use eventually fell off when patients reported high incidence of reactions and other complications.

Another key development in the 1880s was something called “Ringer’s solution—a solution composed of sodium, potassium, and calcium salts,” according to NCBI. Early experiments in frogs showed that replacing blood with the solution could keep the frog alive for a short period, which lent itself to human application. While it is now known that Ringer’s solution cannot replace blood, its ability to increase blood volume means it can and in fact is still used today for such a purpose when it is necessary.

 

Impact of World Wars

The field of transfusion medicine moved leaps and bounds during wartime simply because, well, it had to. Soldiers needed more blood than ever before, and it needed to be transportable and available in large quantities. While no blood substitute was successfully created, during both wars, a big focus was on plasma since it was believed that transfusing plasma could preserve a soldier’s life after shock from blood loss. In the 1920s, for example, scientists developed a gum-saline solution to do the trick, though it had some seriously dangerous health effects and lost favor in the 1930s.

 

Modern Solutions

Flash forward about a century and, unfortunately, we’re still struggling to find a solution. We do have additional insight, though, from the 1980s, which has spurred additional studies and investigation.

Today, if a blood substitute were to be created, it is believed it would fall into one of the following categories: hemoglobin-based oxygen carrier (HBOC) or perfluorocarbon PFC), according to the Pacific Heart, Lung and Blood Institute (PHLBI).

 

HBOCs

The molecules that allow red blood cells in whole blood to effectively transport oxygen are hemoglobin proteins. Per the American Chemical Society, “Scientists have tried developing chemically modified [real human] hemoglobin — which by itself is toxic — as a blood substitute but have found that it forms methemoglobin,” a product that ultimately harms the body’s existing cells. Modern attempts at using HBOCs revolve around finding ways to encapsulate hemoglobin in a way that allows it to carry oxygen without exposing hemoglobin or any other harmful substances directly into the blood.

One HBOC to take note of is Hemapure, which is structurally very similar to another HBOC, Oxyglobin, which has been approved since the 1990s for use in veterinary practices. According to an article recently published in Anesthesia & Analgesia journal, Hemapure is “purified bovine Hb [hemaglobin], chemically cross-linked for stability and formulated in a modified lactated Ringer’s solution [a variation on the Ringer’s solution invented in the 1880s].”

Hemapure is the most widely studied blood substitute in humans. While it is still being researched and has not yet received full FDA approval, it is currently approved for “compassionate use,” or situations when no other treatment options are available. This is often the case when a patient cannot accept blood transfusions for religious reasons, when doctors can’t find blood that matches close enough for the patient to receive safely, or in remote locations where blood cannot be secured in time.

 

PFCs

Unlike HBOCs, PFCs are entirely synthetic, “derived from fluorine- and carbon-containing chemicals, according to PHLBI. PFCs work by particularly useful for “dissolving and absorbing oxygen in the lungs and then transporting oxygen throughout the body.” PFCs post a unique challenge, though, in that they do not mix with blood and therefore need to be added to another solution to be effective — which can cause additional side effects/reactions, depending on what it is mixed with.

While a number of PFCs have gone through trials, there is no clear “winner” when it comes to solving the blood substitute dilemma.

 

Conclusion

If you take anything away from this article, I’d recommend two key points. Firstly, that the search for blood substitutes has been ongoing for hundreds of years, and, while we are making serious gains, there is no clear solution. Which leads us to point two: Until we can create a blood substitute, real live blood donors are our only solution to meeting patient need.

Blood donation is such a unique part of patient care in that it truly requires more than a care team, more than lab staff, more than the latest and greatest inventions. All of those things, no matter how innovative, can do no good without the pure, simple generosity of a community of people who just want to help.





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Donor Center Series: Denton – Carter BloodCare

This article is part of a series highlighting each of Carter BloodCare’s donor centers, their teams, and their commitment to serving their communities by fulfilling the mission to save lives by making transfusion possible.

Loop 288 & I-35E location is convenient for Denton residents, including students and faculty at UNT and TWU

Carter BloodCare’s Tammie Mann has a helpful reminder for Denton residents who want to donate blood to save local lives:

“You don’t have to wait for a mobile blood drive to come to your neighborhood or campus. You have a dedicated donor center right here in town and we’d love to see everyone come here to donate,” she said.

As site supervisor for Carter BloodCare’s Denton Donor Center, Mann is eager to welcome visitors to the location directly across from Golden Triangle Mall on Loop 288 near I-35E.

Open since August 2004, the Denton center has six donor beds and two screening booths. On average, Mann and her energetic team – Phlebotomist 1 Angelica Hernandez, Phlebotomist 1 Jaymee Inman and Phlebotomist 2 Jason Ivey – see more than 125 donors weekly and more than 500 donors per month.

“We have a lot of regular donors who have been coming in since the donor center opened,” said Mann, who has worked with Carter BloodCare for 21 years, including five years at the Denton center. “With the daily need for blood across our area, especially with the ongoing blood supply shortage, we’d love to see a steady increase day by day and bring in more new donors, in addition to our regulars.”

Considering Denton is home to two prominent universities – the University of North Texas (UNT) and Texas Woman’s University (TWU) – it seems natural that education is top of mind as a key strategy for donor outreach.

“It’s important for us to share the benefits of blood donation and awareness of community needs. It’s about education and customer service, and that starts with us when they come in,” Mann said.

With enrollment tallies of more than 40,000 students at UNT and 15,000 at TWU, the pool of potential Denton donors could have a significant, lifesaving effect for area patients in need of transfusions.

“That’s a lot of students and we’re so close to both campuses. Our donors come from all over and we do get some from UNT and TWU, but getting the community more aware that we’re here, especially between those two universities, would be a game-changer,” Mann said. “If we can get them more involved in donating, that would have such a positive impact on our entire community.”

Donors can begin giving blood starting at age 16, with parental consent; those 17 and older can donate blood independently. With that in mind, Mann said it’s also vital to reach out to local teens and their families.

“We want to educate the high schools around the donor center, too, so the younger generation will come to donate,” she said. “It’s so important for them to see the need for blood donation, and how they can give back to support their community across Denton and North Texas.”

Fridays and Saturdays tend to be the most active days at the donor center. Mann and her team readily welcome and accommodate walk-ins; donors are also encouraged to conveniently schedule an appointment by calling or texting 800-366-2834 or visiting CarterBloodCare.org.

“We are here for them and we’re ready to see even more from Denton come in to help by becoming regular donors,” Mann said.Denton Donor Center

“My favorite part of the job is when donors come back to give blood and express what a great job we do,” she said. “They thank us for what we do every day and we thank them for donating to help others.”

Details:

Carter BloodCare
Denton Donor Center
2215 South Loop 288, Ste. 335
Denton, TX 76205
940-383-2055

Hours of operation:
Monday – Friday      8 a.m. – 5 p.m.
Saturday                  8 a.m. – 2 p.m.
Sunday                    Closed

Carter BloodCare’s team at the Denton Donor Center welcomes you for your next lifesaving donation to help Texas patients in need. To find additional donor centers near you, please visit CarterBloodCare.org, or call or text 800-366-2834 for an appointment.

 



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“Blood donors helped save my son’s life.”

Michelle and Jax Fisher




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Donate Blood

This Holiday Season, Give the Gift that Saves Lives

May Peace, Joy and Happiness be yours this holiday season.




  • 1-CBC-0103-COVID-Blog-Header



    We thank you for your interest in donating blood and helping your community. A few eligibility requirements are important to know about during COVID-19. Donation eligibility during COVID-19 You cannot donate if you are inRead more


  • Inventory-Graphic_111521



    Take a look at your community blood supply The need for blood never ends, but the available amount can change from day to day. Blood transfusion is one of the most frequently performed procedures inRead more


  • SPARKing-the-Giving-Season-1200-x-472-px



    SPARKing the Giving Season A new car in the new year? It’s in the bag for one lucky Carter BloodCare donor! Donors that donate blood with Carter BloodCare from Nov. 22, 2021 to Jan. 7,Read more


  • 2021 Veteran's Day



    Donate blood to honor our veterans and current service members This November, Carter BloodCare encourages eligible donors to step up in honor and support of our U.S. military veterans and active duty service members. VeteransRead more


  • Elizabeth Mendez 2



    “I would not be here today if it was not for blood donations,” said Fort Worth resident Elizabeth Mendez. In January 2020, the mother of two had an unexpected and frightening health emergency. Experiencing intenseRead more


  • Donate-blood-this-November-with-Soulmans-Bar-B-Que-1



    For the second consecutive year, Soulman’s Bar-B-Que and Carter BloodCare are teaming up this holiday season to beef up the local blood supply. In the spirit of giving, Soulman’s Bar-B-Que will host blood drives at theRead more


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