Universal blood: One blood type for all

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  Quantumrun Foresight
• April 4, 2022

Insight summary

The concept of universal blood, created by using enzymes to make blood compatible with all types, promises to transform healthcare by eliminating blood shortages and dependence on donations. This development could lead to more lives saved, reduced healthcare costs, and increased resilience against crises, especially in developing nations. However, challenges, such as potential over-reliance on this method, ethical concerns, environmental impact, and unequal access, need to be thoughtfully addressed to fully realize the benefits.

Universal blood context

Researchers in the early 1980s first conceived the idea of universal blood. It revolves around using enzymes to create blood that would be compatible with all other known blood types. Universal blood is blood that can be transfused into any person irrespective of a person's blood type.

There are four primary human blood types: A, B, AB, and O. The differences between these blood types are found in where antigens and antibodies are located within their respective biological structures. Blood type A has A antigens on its red blood cells with anti-B antigens in the plasma, and so forth.

In blood transfusions, persons with blood type AB cannot receive A or B-type blood. Type A cannot receive from B or AB, and type B cannot receive from A or AB. Any attempt to transfer incompatible blood between these blood types may trigger life-threatening immune responses. Type O can be transferred to any blood type without any risk of immune responses because it has no antigens but does include anti-A and B antibodies in its plasma. However, type O blood is in short supply worldwide and is in high demand due to its universal properties. The concept of universal blood seeks to address the short supply of type O blood and meet its increasing demand. 

Disruptive impact

According to research in the 1980s, it was discovered that an enzyme from green coffee beans could be used to create type O red blood cells. These cells would be created using sugar enzymes to remove the moieties with the galactose or terminal N-acetylgalactosamine residues, leaving the core sugar structure on the red blood cells to mimic type O blood. However, blood research experts at the University of British Columbia in Canada say that impractically vast amounts of this enzyme would be needed to create usable amounts of type O blood. Moreover, the enzyme must have type B red blood cells as a necessary starting material. As of January 2022, research was being carried out to develop an improved enzyme to create universal blood.

Generally, only about seven percent of the world's population has type B blood. Type B negative blood is rare as it only comprises two percent of human blood. With it being impossible to transfer blood between non-compatible blood types, universal blood is likely critical to treating whole population groups if it can be developed in sufficient quantities. For example, a patient in the operating room needing a blood transfusion may not have to wait until type O negative blood is found before that person can receive a life-saving transfusion. Universal blood can solve this problem without fear of severe health consequences. 

Universal blood can be stored in facilities similar to blood banks, which are used to store blood donated by the public and are the primary source of blood used in healthcare facilities and hospitals worldwide. Instead of asking for donations, universal blood can be produced in a lab, eliminating the challenge of eliciting donations from members of the public. However, once universal blood is developed on a large scale, the cost of blood transfusions or the sale of blood may differ significantly between public and private healthcare systems. In 2022, two research streams were investigating how to produce sufficient amounts of universal blood and ensuring it can be safely used in real-life environments. 

Implications of universal blood

Wider implications of universal blood may include:

• Eliminating blood shortages in national healthcare systems, leading to a more efficient and responsive medical care, particularly in emergency situations where timely access to blood can be a matter of life and death.
• Eliminating the dependence of blood centers and healthcare systems on blood donations, leading to a more stable and reliable supply of blood, ensuring that medical procedures are not delayed or canceled due to lack of suitable blood.
• More lives saved in public and private healthcare systems as blood will be readily available to administer transfusions if needed, irrespective of patients' blood type, leading to a more inclusive and equitable healthcare system.
• Reduced healthcare costs associated with the blood supply network, especially within developing nations, leading to more affordable healthcare and potentially freeing up resources for other critical health initiatives.
• Nations being more resilient against natural disasters and pandemics that may require sudden spikes of blood transfusions to save lives, leading to a more prepared and agile response to unforeseen crises.
• The potential for over-reliance on universal blood production methods, leading to a decline in traditional blood donation drives and potential vulnerability if the new methods face unforeseen challenges or failures.
• Ethical concerns regarding the production and distribution of universal blood, leading to debates and potential regulations that may slow down the implementation or create barriers to access in certain regions or communities.
• The risk of unequal access to universal blood across different regions and socioeconomic groups, leading to potential disparities in healthcare outcomes and requiring careful policy planning to ensure equitable distribution and access.

Question to consider

• Do you think universal blood could drive up healthcare and blood transfusion costs even if an ample supply is available?
• Do you think blood donation centers will continue to exist if universal blood can be produced on a large scale to meet public health needs?