UBC researchers may have found a way to make donated blood universal | Hacker News Reader

UBC researchers may have found a way to make donated blood universal

vancouversun.com

155 pointsstormbrew36 comments

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This will be helpful if it comes to practical use, particularly for traumas.

But we will still need to test for compatibility.

There are something like 28 different blood groups: Duffy, Kidd, Kell, etc.

People who have antibodies to those other blood groups can have a reaction even if given O negative blood.

(Source: I am board certified in Transfusion Medicine)

Do all those blood groups matter? How many different batches of blood do they need to keep around to handle a majority of the population?

Yes, because life threatening transfusion reactions can still occur if you have antibodies to those specific antigens.

> How many different batches of blood do they need to keep around to handle a majority of the population

I'm the medical director for the blood bank of the only trauma center in an extremely remote location and a catchment of about 100,000 people. We operate our own donor center and do our own crossmatch (tube testing FTW!). We have 45 units of RBCs, 65 units of FFP, and 1 platelet unit for this evening. We also have 3 freezers full of frozen products and closely monitor our usage.

Obstetrics is probably the biggest user, but trauma may be the biggest in any given month. Our high water mark in recent history is 58 units of various products used for one patient a few months ago. We were nervous but got her through it without breaking quarantine to release product (although the quarantine units* were next on the agenda). We pushed 20 units a few days ago for a post-partum hemorrhage.

Quarantine in this case refers to units that have been produced but the infectious disease screening isn't complete yet, so we should not release them for use.

Please donate blood.

Not adding much to the other responses - yes, those other blood groups matter, that's how they found them.

The majority of the population does not have antibodies to the other blood groups - the majority of the population is covered with the basic 4.

Blood group conversion (A, B, and AB to O) would be fantastic - it doesn't solve all the problems.

As stated elsewhere - please donate blood! A lot of the interesting things we do in medicine are predicated on blood availability: trauma, many obstetrics cases, cancer treatment, organ transplant (including bone marrow transplant), major surgeries, etc.

If you can't donate, encourage others to do so!

This could be a revolutionary innovation, just from the perspective of blood logistics. In a perfect world, we'd all stock up on just O-negative blood and use it everywhere but blood supplies are a scarce resource and we have to use what we have so getting all responders to only carry O-negative just won't scale. Imagine removing the tough question about what blood to use: do we use the precious O-negative or do we carry a bit of everything and first test the patient for what can work? By having a relatively plentiful universal supply, we could reduce the amount of carried blood, decrease spoilage and decrease the time it takes to get the patient the blood she/he needs. All these benefits would be massively beneficial in improving patient outcomes, decrease cost and streamline logistics, especially in the field where space is at a premium.

It's obviously early stage, but I'd absolutely love to see the Canadian Blood Service invest in lots of follow up studies to see how we can scale this technology.

Also, it's always great to see my alma mater on HN :)

> In a perfect world, we'd all stock up on just O-negative blood and use it everywhere

Are there any advantages of using blood with the patient's specific antigen type over plain O-negative? Perhaps keeping all blood types available might still be a good idea in a hospital setting.

Plasma compatibility goes in reverse (AB is universal).

And there are lots of other less important blood factors. In most situations the donor blood is cross matched with the patient's blood, to directly test compatibility.

https://www.healthline.com/health/blood-typing-and-crossmatc...

Interesting! Thanks

... never mind the venerable Vancouver Sun - not exactly the first place I look for news like this.

> do we use the precious O-negative or do we carry a bit of everything and first test the patient for what can work?

Type O- is rare because being rhesus-negative is rare, but type O+ is quite common.

Indeed, I am O+ myself

Rhesus negative had the problem of birth issues when their mothers had born rhesus positive elder siblings sadly.

[0] https://en.m.wikipedia.org/wiki/Hemolytic_disease_of_the_new...

In some places, like where I live, rhesus-negative is very rare, 0.2% of the population for O- and B-, 0.1% for A-. It is usually tourists who need the blood and the blood banks just don't have it. So we often see calls go out for blood donors when a tourist has a serious injury. If this method to convert blood works it would be very beneficial.

Key statements:

> Withers and his team previously developed enzymes that were capable of stipping away antigens, but this new kind is much more powerful and efficient.

> An enzyme-driven process was first discovered in 1982 and research has carried on ever since.

> “The (1982) enzyme was incredibly inefficient,” he said. This newly-discovered enzyme is “thousands” times better.

> “The other big key: our enzyme works on whole blood,” he said. Previous research only worked on blood that had been broken down into component parts. With this new process, blood taken straight from donors could be quickly converted into type-O negative, without much delay.

> “If it all works it will have a big practical advantage.”

Wow, I didn't even know this was even mostly possible since the 80s. As exciting as this is, I suppose it's worth waiting and seeing if this is the one that makes it to production.

Headline of article is much less certain:

Researchers at the University of B.C. think they may have found a way to transform a very common type of human blood — type-A — in the universally usable type-O negative.

Ok, we can squeeze a "may" into the title above.

W/o video ads: https://science.ubc.ca/news/gut-enzymes-could-hold-key-produ...

Change headline to type O- they have not managed to make it Rh-negative.

Article says they can convert A-Positive to O-Negative, which means they have removed the Rh.

No other sources I can find on this mention the rhesus factor; I suspect that's a mistake in the article.

Hm... if true, this is both great and scary. The reasons it could be good are covered in the article. I wonder if anyone else can see how dangerous this could also be. Medical research is beautiful but can often be very dark. I would hope there are regulations on usage. Always a shame to see promising research be sold to big Pharma or any other business that doesn't put patient care first.

Why do you say it’s scary / dangerous?

I don’t know the op’s reason. I immediately thought of blood farmers https://www.wired.com/2011/06/red-market-excerpt/

But, uh, I’d hope this tech would help prevent that sort of thing.

I don’t actually think tech is what we need to worry about. My concerns are with access and affordability.

Feel this could be a system that is 1. Not accessible to all 2. Not affordable 3. Could lead to contraindications with other techniques and systems if not implemented properly. I’m optimistic but have also worked in healthcare long enough to understand that these things happen.

Can you elaborate on the dangerous/dark nature of this? Big Pharma does a lot of things wrong, but at the same time private enterprise (big pharma in this case) can be a very effective vehicle for making medical breakthroughs scale to become available to patients.

Absolutely. Speaking with only the knowledge I’ve gained from working at a department that deals with blood banking for a well known university I’d say a lot of outcomes have to do with agendas. No system is perfect and you’re right- there has been a lot of good. My fear is that more “credible” research will be done to “prove” that patients need more medication. I’m not saying don’t take meds if you need them but in many cases they are not needed and can actually be really harmful. All I’m saying is that it can improve life for some it can also reduce quality of life for others.

While I understand why cells have ids on them to be able to detect self from non-self, why is this also happening for blood cells, which are basically just bags with no genetic information inside? What's the evolution reason to guard against a foreign human blood cell?

I'd assume it's because then a pathogen could just make itself look like a red blood cell to dodge the immune system.

Am I wrong in thinking that blood compatibility is basically a big allergy problem?

More generally, an immunological problem.

But... a huge proportion of all human health problems can be considered immunological problems: overactive immunity (transplant rejections, inflammation disorders like Crohn's) or impaired immunity (inability to recognize cancers, acquired deficiencies from infection i.e. AIDS, etc.).

https://www.scientificamerican.com/article/why-do-people-hav... for a decent lay-treatment of the question.

One important thing to remember is that on an evolutionary time scale, the problems that arise from transfusion just started happening. There's been no time to select for them.

Instead, different blood types have different selective advantages that help maintain them, and incompatibility isn't sufficiently detrimental to offset those advantages.

Does anybody have a link to a paper?

I think it's not published yet, at least it doesn't appear in this list of publications: http://www.chem.ubc.ca/stephen-withers#pane-221

There's an older paper from 2015 though: " Toward Efficient Enzymes For The Generation Of Universal Blood Through Structure-Guided Directed Evolution" https://pubs.acs.org/doi/abs/10.1021/ja5116088

This is just a great example of the amazing innovations that come out of socialized medicine. Throw this in the face of anyone who tries to defend private health care on the basis of innovation

I laughed.

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