“Artificial Blood” Makes Its Debut

This article does not constitute an endorsement of the blood substitute PFC (perfluorochemicals). It presents information as to its development and certain advantages it has over many other blood substitutes. It also stresses that much more research needs to be done before PFC can be accepted as completely safe. It is still in the experimental stage, and there is a calculated risk in its use. Its long-term effects are not yet known.

SINCE early last year, a new liquid began flowing through the veins and arteries of certain blood-starved hospital patients. This amazing oxygen-carrying fluid was used, first in Japan, and then in the United States, for emergency situations where, for medical or religious reasons, patients could not receive human blood transfusions. Many of these cases had rare blood types, for which there was no blood immediately available. But a number of Jehovah’s Witnesses, who do not accept transfusions because of the Biblical command to “abstain from . . . blood,” also received this “synthetic blood.”​—Acts 15:20, 29.

One such case was a 67-year-old Witness from Minnesota who, according to Science News, “received two liters [4.2 pints] of the chemicals, constituting about 25 percent of his total blood volume. After that, his condition improved, the artificial blood was slowly excreted from his body . . . and his bone marrow produced enough natural blood to correct the anemia.” He was last reported to be feeling fine. In California, a 65-year-old man received three pints (1.4 L) of the same “synthetic blood” in connection with extensive stomach surgery. He was released from the hospital five days later.

By the end of the year, scores of such emergency cases in Japan and in the United States had been treated with the new blood substitute. News of these developments was headlined in the public press and medical journals around the world. Why is this considered such a medical breakthrough? To understand why, it is necessary to know some of the problems associated with the use of human blood transfusions.

World wide, thousands of tons of human blood are used each year to satisfy the demands of hospitals and medical research facilities. In Sweden alone, with about eight million inhabitants, hospitals annually consume about 220,000 L (465,000 pints) of blood. Keeping this enormous river flowing creates problems everywhere. Scarcity of donors makes it necessary for many countries to import great quantities of blood, often from underdeveloped countries. Such donors may be poor, underfed and even diseased. Prices are high.

Then there are complications arising from using human blood for transfusions, such as hepatitis and various immunological disorders. Furthermore, blood is difficult to handle without damaging and it can be stored for only a limited time, normally about three to five weeks. As much as one third may be wasted because it becomes outdated.

No Easy Task

In view of such problems, medical authorities find it very desirable to have an adequate substitute for natural blood. But it is no easy task to copy such a highly complicated fluid. Here is a partial list of the very complex makeup and functions of blood components:

Makeup and Functions of Blood Components

White cells Combat infections, produce antibodies

Platelets Promote clotting

Enzymes Promote chemical reactions

Hormones Modify enzymatic reactions

Clotting factors Prevent blood loss

These are only a few of the many known components of human blood. And even the functions of these components are not fully understood. More components, as yet unknown, may also exist, since the precise formula of human blood is still the secret of our all-wise Creator. One American researcher prominent in the field of “synthetic blood” is quick to admit that there can never be a true substitute for blood.

Despite its complexity, scientists have been working to copy human blood, or at least to produce a replacement that can temporarily assume some of the functions of the real thing. Examples of such products now in use are dextran, Haemaccel, hydroxyethyl starch, Ringer’s lactate, and common saline solution. However, such solutions can take over only a few functions of blood, and serve primarily as volume expanders. As such, they fill out the blood-vessel system after blood loss, thus preventing sludging of blood cells, until the body itself replaces what is missing.

Developing “Artificial Blood”

One of the greatest disadvantages of volume expanders is their complete inability to carry oxygen to, and carbon dioxide from, the cells, as the red cells in natural blood do. However, over the last 10 years scientists in Japan, Sweden and the United States have been developing a group of substances called perfluorochemicals (PFC) that do have the ability to carry oxygen and carbon dioxide.

The fluorocarbons are inert. They do not seem to react with other substances in the human body, and seem to dissipate from the body in a relatively short time. Not only can they absorb more than twice as much oxygen as can blood, but they also are able to take up or release oxygen and carbon dioxide in just a few thousandths of a second.

Hence, scientists are now able to produce a solution which, in a limited way, may be called “artificial blood.” Since perfluorochemicals will not mix with blood, emulsions must be made by dispersing small drops of PFC (less than 1/10,000 mm or 1/250,000 inch in size) in water in much the same way as cream is dispersed in homogenized milk. This liquid is then mixed with antibiotics, vitamins, nutrients and salts. The final product contains about 80 different components, which seem to be able to take over quite a few of the vital functions of natural blood.

Extensive animal experiments with PFC emulsions have been carried out in recent years. Japanese research showed that rats survive with 90 percent of their blood replaced by PFC. In Sweden and in the United States, rodents have survived comfortably with their entire blood volume replaced. Japanese scientists claim that monkeys have survived with only 2 percent of their own blood left. (See Awake!, August 8, 1979, page 31.)

Many Advantages

According to scientists, PFC emulsions have many advantages. In contrast to natural blood, they are easily kept sterile and can be stored for months or even years. No typing is needed (valuable in emergencies), and there is no known risk of transmitting infectious disease, such as hepatitis, malaria and syphilis.

Other advantages include the ability of the tiny fluorocarbon particles to reach blood capillaries constricted by shock, such as in burn cases. The particles are about one thousandth the size of red blood cells and thus can carry oxygen to areas that would normally be cut off. Scientists have also found that fluorocarbons seem to stimulate greater activity in the white blood cells that fight off disease.

In a recent interview, assistant professor Lars-Olof Plantin, of Karolinska Institut research center, Huddinge University Hospital, Sweden, presented the following list of prospective uses for PFC: cases of emergency; major surgery; carbon monoxide poisoning; acute hemorrhages; chemotherapy; sepsis; removal of toxins, viruses, drugs, and so forth; anaerobe infections; immunological therapy; blood replacement. And American research chemist Robert E. Moore adds: “[Fluorocarbons] could be used to treat various anemias, including Sickle Cell anemia. They could be used to help overcome the effects of heart attack. Because of their inertness, they would be perfect for conducting biological research in that they would eliminate the variables.”

There is, however, much more research still to be done before this substitute can be put to normal use in hospitals. Lars-Olof Plantin and his co-researcher Vera Novácová state that all the body’s vital organs have to be carefully examined to make sure nothing is damaged by PFC. Further research must also make sure that PFC does not interfere with the various organ systems of the body. It is also important to develop the best formula for the emulsion.

Among the remaining unknowns is whether the body can dispose of PFC the natural way, by exhaling and through the skin, at the same rate at which red blood cells are produced. The goal is to find stable PFC-emulsions that are eliminated in about 30 days. Although great efforts are presently being made to solve these problems, it could take years before all possible side effects are sufficiently examined. So use of the “artificial blood” is a calculated risk.

At this time, government agencies restrict the use of fluorocarbon “blood substitutes” to emergency cases only, both in Japan and in the United States. In fact, an official of the U.S. Food and Drug Administration (FDA), Dr. Joseph Fratantoni, reportedly said that the only reason he can conceive for the FDA allowing its use would be religious refusal to permit blood, as in the case of Jehovah’s Witnesses. However, according to the New York Times, the success of fluorocarbons used for the Minnesota Witness mentioned earlier in this article “has had a catalytic effect on American research.”

Such cases may give scientists further information on the effects of those chemicals on the human body. Noting the research potential of such patients, the Los Angeles Times observes: “The fact that many of them probably will be Jehovah’s Witnesses means that their religious conviction may eventually prove to be of benefit to persons of all beliefs.”