Drugless approach that could thin blood during open-heart surgeries tested by BYU researchers

In two new studies published Monday, a BYU research team demonstrates a new approach to thinning blood without injecting a commonly used drug that causes reactions in hundreds of thousands of surgical patients each year.

BYU biomedical engineer Kenneth A. Solen has spent decades seeking ways to prevent adverse reactions when blood contacts medical devices. For example, when patients undergo open-heart surgery, their blood is kept circulating by a machine, but handling the blood with this and other machines causes it to coagulate, or thicken.

"If you do not take some kind of precaution to prevent coagulation, you will have equipment full of Jell-O and the patient will be dead very quickly," says Solen, whose new studies appear in the ASAIO Journal (the journal of the American Society for Artificial Internal Organs).

The current standard approach is to inject a drug called heparin into the patient's blood, which usually works well, but causes negative reactions in three to 10 percent of patients. So Solen's then-doctoral candidate Jared T. Parker worked on a new drugless method to keep blood flowing freely.

"Rather than give something to the patient to prevent coagulation, let's take something out," Solen says. "The concept was that patients wouldn't have a high concentration of a foreign substance in their blood to react to."

The researchers targeted "clotting factors," specific proteins in the blood that carry a strong electrical charge and activate the coagulation process. Using a gel with the opposite charge, the team could attract and remove the desired factors while leaving undisturbed the blood's other vital proteins. Through painstaking laboratory tests, Parker showed that this approach was feasible and determined the necessary amounts of the gel, a process described in the first of the two new papers. The second reports how the process worked during simulated surgeries on animals without introducing any apparent complications during a short-term observation.

Future studies are needed to assess any possible effects after surgery, and then on humans, before the procedure could become common, Solen said.

Parker, now an engineer at W. L. Gore, landed a graduate fellowship from the National Institutes of Health that funded part of these studies. Other funding came from an NIH small business innovation grant to other members of the team at Salt Lake-area company Thrombodyne, Inc. Also assisting with the research were David Beutler, then a BYU undergrad, and colleagues at the Utah Artificial Heart Institute.

Solen's next project looks at using the patient's own blood to create a natural "glue" that could potentially be applied by surgeons to halt bleeding. His team published the results of their laboratory work in April in Translational Research (formerly The Journal of Clinical and Laboratory Medicine).