University of Maryland School of Medicine physician-scientist to lead high-budget research project to develop artificial blood

Despite historic advancements in blood transfusion technology, an estimated 20,000 Americans bleed to death every year before they can be brought to the hospital, according to Dr. Allan Doctor, director of the Center for Blood Oxygen Transport and Hemostasis at the University of Maryland School of Medicine.

“There’s some limited ability to give transfusions in helicopters on the way into the hospital,” said Doctor, a pediatrics professor at the Baltimore-based medical school, “but for routine ambulance runs, all you can do is just drive fast.”

Because of an evolving technology — which just received backing from the Defense Advanced Research Projects Agency — in the not-so-distant future, doctors might have a better way of buying time for traumatically injured patients, and potentially saving their lives.

In the coming years, Doctor will lead scientists from more than a dozen universities and biotechnology companies in developing a whole blood product that is easy to use in transfusions and able to be stored at room temperature.

DARPA, a research and development agency that’s part of the U.S. Department of Defense, is providing $46.4 million in funding for the four-year research project, the University of Maryland School of Medicine said in a recent news release.

The agency has long been interested in developing a shelf-stable whole blood product that could be used for transfusions on the battlefield, Doctor said. Fighting has changed since World War II, when field hospitals were set up just behind the front lines. Now, there aren’t clear battle lines. Injured soldiers could get trapped in cities for days at a time, with no official medical center nearby.

In Afghanistan, Doctor said, it’s estimated that between 70% to 80% of people who died in the field could have lived, if it had been possible to give them a blood transfusion outside a hospital.

To improve chances for survival, patients should have access to blood in 30 minutes or less, DARPA said in a recent news release.

“When blood donations decline — as we have seen during the COVID pandemic — that threatens availability everywhere, even in high resource settings,” said Cmdr. Jean-Paul Chretien, a U.S. Navy medical officer and DARPA’s program manager for Fieldable Solutions for Hemorrhage with bio-Artificial Resuscitation Products. “Blood availability also could be at risk in military engagements with large numbers of casualties, with a sudden and significant increase in need.”

Under the limitations of current whole blood transfusion technology, doctors are beholden to the availability of donors. Blood for transfusion also must be stored in a cold place, and lasts for only about 40 days.

Doctor and his colleagues are trying to create a product that has a long shelf life, is easy to transport and doesn’t need to be chilled.

“That’s the principal goal. It’s not to replace natural blood in hospitals, but to make transfusion therapy available outside of hospitals at the point of injury in austere settings,” he said. “That could be somebody trapped in a car on 83 North. It could be someone on a mountain in Afghanistan who’s been shot. It could be someone on the space station. It could be someone on a cruise ship.”

The final project will include ErythroMer, the artificial blood product made by a company that Doctor founded in 2016 with Dipanjan Pan, a professor in nanomedicine at Penn State University, and Dr. Philip Spinella, a military transfusion medicine expert at the University of Pittsburgh.

It also will include a freeze-dried plasma product made by the Pennsylvania-based medical device company, Telefex, and a synthetic platelet product that was first developed by Anirban Sen Gupta of Case Western Reserve University, and continues to be refined by the Ohio-based Haima Therapeutics.

The final product that Doctor and his colleagues envision creating will be able to last for years, even in extremely cold and hot environments, and will be simple enough to be used by an 18-year-old medic in a battle setting.

They picture the product being stored in a bag with four compartments — one filled with water, the rest with the freeze-dried platelets, plasma and red blood cells. When someone needs a transfusion, a medic will twist the bag, breaking the barriers between each compartment and mixing everything together.

Doctor estimates it will take between eight and 10 years for the combined product to be available for commercial use. While the freeze-dried plasma has been through clinical testing and is waiting for licensure approval by the Food and Drug Administration, the platelets and artificial red blood cell products are both still working to get permission to be tested on humans, he said.

The road ahead of him and his colleagues is complicated, he said.

“It’s like a moonshot,” he said. “You have to break down each element and solve these problems one by one, and not add complexities that aren’t necessary to achieve the immediate goal, which is to be able to resuscitate somebody.”

To help them make decisions and accelerate their research, Doctor and his colleagues will be using artificial intelligence and machine learning technology that was designed by a team of scientists at the University of Maryland School of Pharmacy to optimize drug development.

On average, it takes about 10 to 12 years — and about $1.2 billion — for a new drug to enter the market, said Joga Gobburu, director of the pharmacy school’s Center for Translational Medicine. Using artificial intelligence in research could save scientists anywhere from one to five years, he said.

Down the road, Doctor said, he and his colleagues hope to further explore the potential of artificial blood, including using it to support patients on bypass machines and to make organs last longer after they’re removed before transplant.