Can blood be universal?

Story by: David Lynch 

The key to making blood universal lies in a part of a body you’d never expect — the human gut.

Ontario Paramedics Association president Darryl Wilton says that this could positively affect patients when there’s a shortage of a certain blood type.

“I’ve seen situations in rural areas where we have blood being shipped up the highways by both paramedics and OPP (Ontario Provincial Police) officers,” Wilton says. “They’re usually calling for very specific blood types because shortages happen frequently.”

University of British Columbia professor of chemistry and biochemistry Stephen Withers likes the idea of universal blood because of the flexibility it gives to the blood supply that hospitals have.

“It would broaden the blood supply,” he says. “The reason they want O type blood is because it can be donated essentially to anybody.”

Withers and his team have been working for three years on the approach to use the gut to make universal blood. The goal of this research is to convert A and B type blood to the universal O type because of O’s ability to be used in almost every patient.

“It turns out it’s possible to convert A to O, or B to O if you can cut off the specific sugar that specifies A or B,” Withers said.

Withers first started looking in the gut because he knew he needed a specific enzyme that could change the sugar structure of the cell.

“The gut wall is lined with specific sugar structures, including those same A, B, and O structures that are on the red blood cell surface,” Withers says

“The reason they want O type blood is because it can be donated essentially to anybody.”

Even though they will need to look at enzymes for both A and B blood types, Withers says for now, they’re focusing on finding the enzyme for A. That is because A is the more difficult type to find a fit for. Once they find a fit for A, it should be easier to find one for B.

Wilton says converting A and B to a universal type will help both patients and first responders. When paramedics have a patient who is losing blood, they try and stop the bleeding while simultaneously taking the patient to a hospital.

The paramedics also page the hospital to let them know how much blood has been lost. This gives the hospital an accurate idea of how much blood is needed for the specific patient. But with most patients, what they don’t know is the blood type.

“Most of those patients are unconscious, so we don’t know the blood type on route to the hospital,” Wilton says. “It means on arrival the first volume they’re going to put in before they screen the patient is going to have to be universal blood type.”

Before the new O blood can be used in patients, it has to go through multiple tests. Withers says the next step is safety testing, which involves mixing the converted A and B blood with other blood, to make sure there aren’t any negative reactions. Next is putting the blood into actual people.

It’s a process that can take years.

“You have to go into these sorts of experiments pretty slowly because bad things could happen if you don’t do it carefully,” Withers says.

If all goes well, the project may be completed in the next five to eight years.

“This is going to take quite some time because, understandably and completely correctly, you have to go into those sorts of experiments pretty slowly because bad things could happen if you don’t do it carefully.”

Withers’ goal is to have this used widely, and for this research to help minimize situations when blood supply is low.

“(The goal is) To have this available in use broadly in the clinics and help to ease up the emergency situations when there are shortages of blood. Hopefully, minimize the situations when they have to do these emergency calls.”

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