Will Artificial Blood Ever Replace the Real Thing?

It's no secret the United States is facing a blood shortage. For many years now, blood banks have tracked decreased numbers of donors among younger generations. To make matters worse, donation rates plummeted during the Covid pandemic and have yet to fully recover.

Enter artificial blood.

Wouldn't it be wonderful if blood could be produced in a lab, circumventing individual acts of generosity? Imagine it: if blood could be easily manufactured, that would mean no more blood shortages. No more needless tragedies. And yes, it would mean you'd be hearing from us a lot less!

Of course, that's not the world we live in. The promise of artificial blood hasn't yet been fulfilled. With millions of blood-related deaths happening every year around the world, it does make one wonder: Why hasn't it? What's stopping it?

Artificial Blood's Beginnings: A Search for a Substitute

Here's something you may not know: The scientific community's quest for artificial blood actually predates the practice of blood transfusions itself.

In fact, some of transfusion medicine's early pioneers were injecting patients intraveniously as far back as the 1600s. Unfortunately, the products being injected — milk, urine, ale, lamb and cow blood — couldn't quite replicate the real thing.

Early blood transfusion between a lamb and a human

Astonishingly, some patients did respond positively, especially those patients transfused with milk. The problem, of course, was that only some patients were helped. Others weren't so lucky. Milk, the medical community would come to understand, didn't always do a body good.

If these examples sound outlandish, it's important to note that human-to-human transfusions weren't much better in those early days. Most doctors understood that human blood was a vital resource, some even going so far as to ascribe cure-all qualities to it. Have stomach ulcers? Want to change an aspect of your personality? Four hundred years ago, you might have been prescribed a blood transfusion.

Blood Transfusions: Karl Landsteiner to Now

It wasn't until the early 1900s that transfusion medicine experienced a much-needed breakthrough. Austrian-American biologist and physician Karl Landsteiner discovered the existence of different blood groups in humans — A, B and C, he called them, the latter eventually becoming O.

This proclamation from Landsteiner, now widely considered "the father of immunology," accelerated advancements in transfusion medicine like never before. His work would earn him a Nobel Prize in 1930.

Despite the field's many advances related to testing, sterilization, preservation, distribution, the reliance on human blood for transfusions does still have one major flaw: supply and demand.

Only 3% of eligible donors in the United States give blood at least once a year, according to America's Blood Centers and the Association for Blood Donor Professionals. And in rural areas and countries with fewer medical resources, those percentages are even lower.

Those numbers highlight the precarious nature of the world's blood supply and explain why interest in a blood alternative has persisted well into the 21st century.

Emerging Strategies and Products in Artificial Blood Development

Fortunately, the days of milk transfusions are behind us. Today, researchers are exploring a variety of lactose-free approaches in their quest for artificial blood, from synthetic oxygen carriers to lab-grown red blood cells. Here are some of the most promising developments currently underway:

Hemoglobin-Based Oxygen Carriers (HBOCs)

These synthetic blood substitutes use modified hemoglobin to transport oxygen without the need for red blood cells.

Perfluorocarbon-Based Oxygen Carriers (PFCs)

These synthetic molecules can dissolve and transport oxygen efficiently, making them useful in trauma and surgical applications. However, they require supplemental oxygen and have compatibility issues with the immune system.

Stem Cell-Derived Red Blood Cells

Researchers are using induced pluripotent stem cells (iPSCs) or hematopoietic stem cells to grow lab-made red blood cells. This approach could provide a renewable source of blood, but scalability and cost remain obstacles.

Genetically Engineered Hemoglobin

Scientists are modifying hemoglobin to enhance its stability and oxygen-carrying efficiency. Advances in protein engineering could lead to safer, more effective synthetic blood products.

Microfluidic Blood Substitutes

These involve nanoparticles or bioengineered carriers designed to mimic red blood cells. They aim to improve oxygen delivery while avoiding immune system rejection.

Universal Blood Substitutes

Efforts are underway to create blood that works for all blood types, reducing reliance on donor blood. This could revolutionize emergency medicine and transfusion logistics.

Will Artificial Blood Ever Actually Happen?

While it's impossible to accurately predict whether the centuries-long promise of artificial blood will ever bear fruit, it's hard to imagine a world in which blood would no longer be needed.

Take ErythroMer, for example, the latest buzz-generating HBOC to show real potential as a blood alternative after an encouraging round of pre-clinical trials in the spring of 2024. ErythroMer mimics one of blood’s functions — oxygen delivery — but it contains no platelets, plasma, white blood cells or clotting factors.

So even in a best-case scenario, ErythroMer wouldn't be able to fight infection, stabilize body temperature, transmit hormones or stop a cut finger from bleeding. We'd still need whole blood to do all that.

Perhaps there is a Karl Landsteiner midway through transfusion medicine's next great breakthrough; only time will tell. All we can say for sure is that blood donors provide something to patients that nothing else has ever been able to match.

If you've never given blood before, that's OK! We invite you to come to any of our 17 donor centers across Oklahoma, Arkansas and Texas, or to a blood drive near you. And if you're a regular donor, come see us when you're next eligible! We appreciate you as always.

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