Shortage of blood and doctors: Are artificial blood and telemedicine the future of medicine?

In many countries, there are too few blood donors and too few doctors. Are artificial blood and telemedicine the solution?

Blood supplies are low around the world. According to the World Health Organization, in many countries, there is a problem of providing enough blood with a guarantee of quality and safety.

Of the 118.5 million blood donations annually worldwide, 40 percent are collected in high-income countries, where only 16 percent of the world’s population lives.

However, even in these countries, there is a constant need for blood supplies. Often, even cash payments, attractive gifts, or vouchers cannot convince enough people to donate blood. In Germany alone, around 15,000 cans of blood are needed every day.

What tests are performed on blood donors?

Whoever wants to donate blood must be healthy – for the protection of the donor and the recipient.

In order to rule out infection, body temperature, pulse, and blood pressure are measured, as well as the concentration of red blood pigment (hemoglobin) – with a small prick in the tip of the finger or earlobe.

Blood is tested for antibodies against various viruses: hepatitis, HIV, syphilis, and parvovirus B19 infection. Doctors then check the registration form. If everything is in order, the blood donation can begin.

Telemedicine blood donation

Since this check does not have to be carried out by doctors, in Germany their presence is no longer necessary when donating blood.

This applies from 2023 when the use of telemedicine procedures is enabled.

Non-medical specialists carry out blood draws, and examinations and can provide first aid in emergencies. The doctor is connected via video.

Telemedicine blood donation is intended primarily for people who donate blood regularly.

The German Association of Doctors reacts very critically to it.

“Through the video, doctors cannot assess the actual state of health of a potential donor very well: is he breathing well, is he pale or are his lips slightly bluish? If I am sitting opposite the person, this assessment is easier,” says Sven Pajne, doctor and head of the Institute for Transfusion Medicine at the University Hospital Hamburg-Eppendorf.

However, patient representatives expressly welcome the new regulations.

The umbrella organization for chronically ill and disabled people and their relatives with around one million members advocates “simplification of regulations for donating blood and plasma because those affected always have to fear that there could be shortages, especially of plasma”.

Does artificial blood solve problems?

Artificial blood could be another solution to blood shortages – especially for patients with rare blood groups or specific intolerances.

In total, there are more than thirty different blood group systems. The ABO system of blood groups and the Rhesus factor are crucial for blood transfusion. Only blood group 0- can be used universally, but donors with this blood group are very rare.

In April 2024, researchers from Denmark and Sweden managed to convert blood from groups A and B into blood from group 0.

This is made possible by the use of enzymes from intestinal bacteria. A 2019 study has already shown that enzymes enable such a conversion.

Successful transfusion of red blood cells

The production of blood platelets (thrombocytes) and, above all, red blood cells (erythrocytes) is very complex because these nucleated cells must originate from special cells in the bone marrow.

Newer approaches focus on genetically modifying cells so that they can produce larger amounts of red blood cells.

The first transfusions of artificially produced red blood cells have already been performed in France and Great Britain.

However, in very small amounts, which were only about one percent of the content of a regular blood donation.

There were no complications or side effects. The results were hailed as a medical breakthrough.

Risks and challenges of artificial blood

The development of artificial blood is not without risks. Immune reactions can occur if the body reacts to foreign enzymes or artificial blood components with anaphylactic shock and thus life-threatening reactions.

It must also be ensured that artificial blood can fulfill all the functions of natural blood – whether it can be adapted to different blood groups and the specific requirements of the recipient.

All in all, it will be years before artificial blood is available in sufficient quantities and with the necessary safety for widespread use.

Until then, blood donation remains essential for transfusion medicine.