Change your blood type?
Company's effort may make transfusions universal

By David Rattigan,
Globe Correspondent, 1/9/2003

It may sound like science fiction, but a company in Beverly has created a system that can change your blood type. In doing so, it may transform transfusion medicine.

ZymeQuest Inc., a 20-employee company located at the Cummings Center in Beverly, has developed a system that can convert A, B, and AB red blood cells to what it calls ''enzyme converted group O'' (ECO) red blood cells, which replicate the qualities of group O cells.

Why is that important? Because transfusions from some blood groups may be harmful to a recipient whose blood type doesn't match. Group O blood is the only type that can be transfused safely into people of all blood types, which puts it in great demand.

What complicates the process of matching supply (the blood banks) to demand (hospitals) is the randomness of the demand, the need to match blood types correctly, and the 42-day shelf life for blood donations. For that reason, blood is constantly transported from one spot to another.

''There's a rather remarkable disconnect between the supply side and the demand side, on a daily basis,'' said Douglas Clibourn, ZymeQuest's president and CEO. ''There's an extremely complex and difficult logistical system in place to make sure the right amount of the right blood group arrives at the right place at the right time for the patients who need it.''

Clibourn, who lives in Boxford, has run ZymeQuest since 1992. The former Marine had previously worked in management for regional blood banks, for the medical products company Haemonetics Corp. (most recently as head of its blood bank products division), and as a health care consultant.

The ZymeQuest system, which will be sold to regional blood centers, is undergoing clinical trials, and the company hopes to bring it to market in 2005. The privately held company is courting investors for what Clibourn hopes will be ''our last private financing.'' The fully automated system uses enzymes and other solutions, plus a sterile plastic, single-use disposable processing kit in which the conversion takes place. In the simplest terms, the enzymes and other solutions mix with and remove the structure of the antigen specific to types A, B, or AB blood, creating enzyme converted type O blood. Type O blood cells created in this way are clinically and functionally the same as group O red blood cells, according to Clibourn.

Eight of the company's 20 employees are scientists and eight are engineers. It uses outside manufacturers, as well as scientific and medical advisers. ''It's been very gratifying to see that people with significant expertise in the areas that we need to finish the development of our technology have been more than willing to work with us,'' Clibourn said.

One of those is Dr. Margot Kruskall, director of the Division of Laboratory and Transfusion Medicine for Beth Israel Hospital and professor of pathology at Harvard University Medical School. She chairs ZymeQuest's medical advisory board, sits on the scientific board, and has a research grant from the company.

There have been a number of ''modest attempts'' to do this over the past 30 years, Kruskall said, since scientists realized how ''tantalizingly simple'' the differences were between the cells in the blood groups. As with many scientific projects, the devil has come in the details. In the case of ZymeQuest, she can see an end point.

''There are still a moderate number of scientific hurdles, then a larger number of FDA and clinical trials hurdles, but all of them I see as surmountable,'' she said.

C. Evan Ballantyne, ZymeQuest's vice president and chief financial officer, said that with a hypothetical 100 percent market penetration, the company could save a net $800 million per year for the $5.2 billion blood industry. Hospitals typically pay $200 per unit of blood, then spend another $200 per unit on blood typing and cross matching, and inventory control. A universal blood supply would eliminate much of that, and would save the blood bank in areas of recruitment and collection, processing, testing, inventory control, and transportation. Also, according to the National Blood Data Resource Center, 5 to 6 percent of the 13 million blood units transfused yearly are lost due to outdating (blood has a 42-day shelf life). That percentage would be reduced significantly.

Although he has no direct affiliation with ZymeQuest, Dr. Ronald Gilcher, president, CEO, and medical director of the Oklahoma Blood Institute, is familiar with the company. The institute, a large regional blood center that services 92 hospitals, may become a site for advanced clinical testing.

Approximately half of the blood units handled by his center are group O, but demand exceeds supply. ''Our recruitment people are constantly calling the Os,'' he said, adding that group 0 negative is particularly in demand. (The ZymeQuest system doesn't change the positive or negative qualities of the blood type.)

Most emergency rooms will transfuse group O blood units until they have determined the patient's blood type. Some emergency rooms use only group O, as do some military units. Following the Oklahoma City bombing, the Oklahoma Blood Institute forwarded group O blood units to the emergency sites.

''The world is changing, unfortunately, with terrorism issues,'' Gilcher said. ''An all-group O system will make it much easier to handle blood issues anywhere in the country, or in the world.''

The world is also graying, with a large senior population expected to live longer than previous generations. Some lives are prolonged by better medicine, and with advances in medicine come more surgical procedures, and more of a need for blood, Clibourn. Meanwhile, concerns about infectious diseases are reducing the donor pool.

''People who could have been donors in the past can't be donors, or have been postponed,'' Ballantyne said. ''I lived in Europe for three years and I can't donate blood because of fear of Mad Cow Disease.''

Clibourn said he believes his company can resolve many blood supply issues.

''The people in the trenches [of transfusion medicine] work diligently to make sure everybody has blood when they need it,'' he said. ''This technology will be able to ease those difficulties for maximum use of available blood inventory.''

This story ran on page 1 of the Globe North section on 1/9/2003.