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Comment by toomuchtodo | Hacker News Reader

Can a domain expert comment if this does away with the whole blood donation/testing/storage/logistics system we currently have?

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Once in full production, potentially. But currently it's only been tested on rabbits. This could change the face of medicine if successful.

> This could change the face of medicine if successful.

Why? Is blood shortage a serious problem in medicine?

Yes, blood shortages are a frequent occurrence, as it's dependent on the frequency and volume of volunteer donors.

If this is solution can be scaled up, you would negate the need for the entire blood donation and plasma collection (which is paid for, at least in the US) system overnight. It's a Big Deal.

An “unlimited blood budget” might obviate hemodialysis in favour of just doing a “blood change”, which—depending on how you do it—may protect the liver and kidneys from things we can’t manage to pull out in a single hemodialysis pass.

It might also change the face of surgery. You know the phrase “he’s bleeding out!” Well, who cares? We have blood pressure to spare, now. We could go through a couple gallons during the surgery and it’d be fine. Just hook them up to the tank. Take your time clamping/microsuturing/cauterizing instead of rushing and making mistakes.

Uuuh no. Real blood unfortunately does more than transport oxygen. So "hook them up to the tank" isn't a solution, and isn't a problem only in a surgeon's mind.

What other functions of real blood do you have in mind, that this doesn't at least have the potential to do well for a short period of time in emergencies?

Well, what about immune function? It's pretty interesting to have one when and after you're bleeding out...

And before you tell me the potential is there, please realize that we currently have only a very partial understanding of how that works, and it would certainly require at least two decades of science to get right.

I was asking, not arguing.

Ok, sorry

I was talking about what this technique would do “if successful”—as in, if developed further. A full solution would likely include “generic” platelets and innate-immune cells into the mix, genetically-modified such that they don’t present graft-host disease; but would likely leave out adaptive-immune cells, leaving those to the marrow to reproduce.

(Or, helpfully, not; a “complete blood transplant”, done at the same time as a bone-marrow transplant, would serve as a much more immediate reinitialization of the body’s immune system in the face of autoimmune disease. Right now we try to do that with hemodialysis, but although we filter out the memory B- and T-cells themselves, we don’t manage to [immediately] filter out their chemosignals, so autoimmune response currently continues for a few days.)

In under-developed countries like Nepal, yes. Every year women from rural villages lose their lives because of excessive bleeding. No nearby health facility has a blood type segmentation facility; let alone a blood bank. If the government could provide the artificial blood to such rural villages, we could expect to reduce the maternal mortality rate of Nepal to a great extent.

So the core issue here is you can't know what type of blood to give? Why would artificial blood solve the problem of no nearby blood banks?

If artificial blood has different storage requirements than the real thing, perhaps it'd be easier to have more and more remote blood banks?

Per the article, natural blood has to be refrigerated and only lasts for a few weeks, while this stuff is good for over a year at room temp. You wouldn't need a blood bank. Every local clinic could keep a few bags in the supply closet.

It's not just blood shortage in total numbers (which is a problem), but people who receive transfusions often develop additional antibodies, which makes it even harder for them to receive compatible blood in the future. There are actually millions of "varieties" of blood not just the 8 main types. It can be so hard to find a successful match that blood is sometimes shipped internationally. Emergency situations can be particularly difficult.

https://www.smithsonianmag.com/science-nature/your-blood-typ...

If significantly fewer people were encouraged to donate, I wonder what that would do to the pool of bone marrow donors.

At least in Australia you're encouraged to sign up for this as you donate, which makes it very easy for them to run the needed tests.

It depends on how much it costs and how well it works (in the humans), neither of which is known at this point.

A cost competitive artificial blood that works as well as whole blood would have a big impact on the current system. An expensive replacement that wasn't as effective for treatment but had longer shelf life or something like that wouldn't have much impact.

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