In a medical first, a revolutionary synthetic blood has saved the life of a Victorian woman. Doctors at The Alfred brought Tamara Coakley, 33, back from the brink of death after a horrific car crash left her with severe blood loss and dangerously close to heart failure.
This is the first reported case of the synthetic blood reversing cardiac hypoxia and anaemia in a trauma patient. They tried to save her using 10 units of the haemoglobin-based oxygen carrier, called HBOC-201 that had to be flown in from the US. The synthetic blood contains a molecule derived from cow's blood and restored the level of haemoglobin in her blood, which carries oxygen to the tissues.
According to trauma service director Dr Mark Fitzgerald, it marked an important step in developing a viable blood alternative to address world blood supply shortages. Unlike donor blood it does not require matching and can be stored without refrigeration for up to three years- making it suitable for use in rural settings or on the battlefield he noted. “It's a bit of science fiction,” Dr Fitzgerald admitted. “Currently only one in 30 people give blood, but one in three will need it…What we would eventually like to see is synthetic blood products to be available in remote areas of Australia and in the Defence Forces when people don't have any other option,” he said.
As a Jehovah's Witness, Mrs Coakley was unable to have whole blood transfusions, but was permitted to accept blood substitutes. Dr Fitzgerald added that he was familiar with the product, which is being developed by the US Navy, because he gave independent advice on a proposed research project five years ago. Working through the night he negotiated with the drug's manufacturer, OPK Biotech, the Therapeutic Goods Administration, the Australian Quarantine and Inspection Service and airline carriers.
The Alfred's ethics committee also approved the import and permission was granted under the TGA's special access scheme and the manufacturer picked up the tab. Within 48 hours, the blood product had arrived in Melbourne and five units (2350ml) were painstakingly administered over two days. Mrs Coakley did develop some problems including high temperatures and pneumonia but her haemoglobin levels more than doubled.
HBOC-201 is one of several blood substitutes being developed around the world. University of Melbourne Paediatrics Department head Prof Paul Monagle said synthetic blood could relieve donor supply issues and give people in remote areas access to life-saving treatment. “The other issue is storage…If you could make a synthetic blood with a long shelf life and it was portable you could carry it with you,” he said.
But experts add that any synthetic blood product would have to be rigorously tested before it moved from working prototype to routine practice.
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