A new initiative by the San Diego Blood Bank highlights how the region’s leadership in genomic research and innovation is bleeding into new areas of healthcare.
The Precision Blood initiative is based on medical research showing that there are over 30 blood groups containing over 300 antigens which impact how well a person will respond to blood transfusions or match with a donor. Currently, only the two blood groups and three antigens that make up the widely known blood types of A+, A-, B+, B-, AB+, AB-, O+ and O- are typically considered for routine transfusion.
For patients who need a one-time blood transfusion, matching donated blood by the standard type is typically safe. However, patients who receive multiple transfusions can be at risk of adverse transfusion responses to antigens in donor blood that does not precisely match because the body recognizes the difference in red blood cell antigens that may cause a patient’s immune system to reject transfusion. Between 14% and 44% of chronically transfused patients develop antibodies against red blood cells, which may cause transfusion reactions and negative health outcomes including a decreased life expectancy.
“Ultimately, we want to help as many patients receive the best matched blood available when needed,” said Dr. Mark Edmunds, chief medical officer for San Diego Blood Bank. “For example, when a patient receives specific blood matched with a donor of similar racial or ethnic background, there may be a decrease in adverse transfusion reactions and improved clinical outcomes.”
Leader in Innovation
Precision Blood is the result of a years-long concerted effort by San Diego Blood Bank (SDBB), which also operates as Southern California Blood Bank, to become a leader in innovation.
The effort was spearheaded by former SDBB CEO David Wellis who stepped down in 2021 to lead Community Bio, a cell therapy Contract Development and Manufacturing Organization that was spun out of innovations developed at the blood bank.
“Most regional blood centers don’t participate or get too involved in the research or innovation side,” said SDBB Chief Business Officer Nikhil Nayak, adding that the blood bank envisions San Diego as a “center of excellence” for innovation in blood supply research. Precision Blood is the latest ambitious program developed by SDBB.
“Precision Blood is really focused on genetics – the next generation sequencing of, specifically, the red blood cell,” he said. “That’s where our expertise and core competence lie.”
SDBB put the idea of using genomics to match patients to more similar blood into motion last year following a $50,000 grant donation from the David C. Copley Foundation to purchase an Illumina sequencer, and a $726,000 grant from The Conrad Prebys Foundation that funded the work of getting 30,000 of donors Precision Blood typed, utilizing an assay developed by HaploGNX.
“We were able to find rare donors, we were able to find better matches for what hospitals were looking for,” Nayak said, adding that the effort advanced the initiative to a “proof of concept” that can lead to the expanding and scaling up needed to show the clinical outcomes of Precision Blood.
The expansion of Precision Blood has already begun with partnerships with national organizations like the National Blood Collaborative and Blood Centers of America, who provide access to blood samples from across the country to identify more genetic markers for matching donor blood to patients.
“We recognize every patient is an individual and their treatment should be tailored for that individual,” Edmunds said. “The more closely your donor looks like you in terms of your genetic background, the more likely a transfusion is going to be successful.”
Over the next two years, SDBB aims to further expand the diversity of blood products while partnering with hospitals and biotechnology organizations to expand lab capacity and conduct the research needed to scale the Precision Blood typing process so that these closely matched blood supplies can be delivered to any patient who needs them.
Current hospital and laboratory partners include Rady Children’s Hospital-San Diego, Kaiser Permanente-San Diego and Harbor-UCLA Medical Center.
To facilitate the expansion of Precision Blood, SDBB is currently looking to raise $4 million.
Nayak said the money will be spent “roughly” $1 million each for more sequencing runs; staff for clinical studies; the clinical studies themselves; and lab space and equipment. SDBB currently only has lab space capacity to run 15,000 samples per year and needs a tube sorter to help clinicians and researchers more quickly get to the correct blood sample.
“What we’re hoping is that working with biotech and pharma on the research and innovation side will help us continue to get funding or make this a little bit more revenue generating so we can pour it back into making this become the standard of care for communities globally,” Nayak said.
In addition to cash and in-kind donations from wealthy individuals, hospitals and biotech companies, SDBB is also requesting the public do what it always requests the public to do – donate blood.
SDBB donors are 63% Caucasian, 1.5% Black and 11.6% Hispanic. The organization is hoping that more diverse donors, particularly those who identify as Black and Hispanic, will step forward to make Precision Blood more impactful for more patients.
San Diego Blood Bank
CEO: Doug Morton
Headquarters: San Diego
Business: Nonprofit organization supplying blood to hospitals throughout Southern California
Revenue: $50-$55 million (FY2022)
Notable: Nine sites in San Diego and one in Orange County