Headlines
As reported by The Hartford Courant, May 7, 2008.
A Better Blood Vessel
By Janice Podsada
WINDSOR – Ron Salonia, a medical technician at the University of Connecticut Health Center, operates the heart-lung machine during open-heart surgery.
But he doesn't like giving blood. His reluctance has nothing to do with a fear of needles or feeling faint. Like a growing number of medical professionals, Salonia prefers not to give heart patients a blood transfusion unless necessary.
While transfusion techniques have grown increasingly sophisticated, recent studies suggest that "receiving someone else's blood is not as beneficial as one may think," said Salonia, who is a perfusionist, a technician who runs the machines that take over the functions of a patient's key organs during surgery.
Most patients experience some form of immune reaction when they receive donor blood. That reaction can be as mild as a slight increase in temperature or as severe and life-threatening as multi-organ failure, said Keith Samolyk, 48, founder of Global Blood Resources LLC, a 4-year-old Windsor company.
Someone undergoing open heart surgery doesn't need additional complications. And heart patients may not be healthy enough to "bank their own blood," which can be stored for only about 40 days, Samolyk said.
"Blood is alive. It's living tissue. When it's not in your body, it's not getting the nutrients it needs. As donor blood approaches the expiration date, the red cells become less flexible. Their potential for clogging the capillaries increases," he said.
"Blood transfusions are for lifesaving emergencies — when there's been significant blood loss, when you've been in an accident or been shot."
Samolyk, a practicing perfusionist, is the inventor of the Hemobag, a patented medical device that returns the patient's whole blood in a concentrated form to him or her after cardiac surgery.
Samolyk, who refined the device at his parents' kitchen sink in Windsor, used his retirement money, "well over $100,000," to finance his venture.
In 2004, after receiving U.S. Food and Drug Administration clearance for the Hemobag, Samolyk began marketing it. Global Blood Resources now supplies 62 medical institutions across the nation, said Samolyk, who declined to provide any financial details about the company.
"Nobody has anything like this on the market," he said.
That distinction drew the attention of the Connecticut Technology Council, which named Global Blood Resources one of this year's 14 most promising early-stage companies.
When a patient undergoes open-heart surgery, the heart must be stopped and the patient hooked up to a heart-lung machine, which essentially becomes "your life support," Samolyk said.
Last year, more than 325,000 patients nationwide had open-heart surgery using a heart-lung machine.
"From door to door, the typical procedure lasts about four hours," Samolyk said. "During that time I'm controlling all your bodily functions: maintaining body temperature, urine output, blood pressure and oxygenation. I do everything your body would do."
When the operation concludes, there are usually 1 to 2 liters of blood left in the heart-lung machine, a significant amount because the average adult has about 5 liters of blood in his or her body, he said. Returning the blood to the patient can help promote healing and avoid the need for a blood transfusion.
But it's not as simple as it sounds. Before the blood can be returned, it has to be carefully flushed from the machine so that no air bubbles are introduced into it. Perfusionists have traditionally used devices called cell-savers to salvage the blood. However, they save and return red blood cells only.
"I saw this as a huge problem," Samolyk said. "All this precious stuff was going down the drain."
Blood is made up of several major components: red cells that deliver oxygen, infection-fighting white cells, platelets that help staunch bleeding, and plasma that contains clotting factors and albumin, which helps regulate blood pressure.
Returning whole blood — not just red blood cells — to patients who've just emerged from open-heart surgery can really perk them up, Samolyk said.
"It's like spinach for Popeye," he said. "People stop bleeding. It stabilizes the patient's blood pressure." In the course of an operation, however, a patient's blood becomes diluted with intravenous fluids and medications. So before whole blood can be returned to the patient, those foreign elements and the extra fluid must be filtered out. Developing a system that would remove them and still capture all of the blood components became Samolyk's passion.
About 10 years ago, "I woke up in the middle of the night," he said. "It just went 'ding!' in my head and I got up and wrote it all down."
He adapted a filtration technology similar to that used in dialysis to create the technology behind the Hemobag. He tested prototypes at the kitchen sink.
"I'd hook it up to the faucet, and circulate water through it to observe the rate of flow." To adjust the flow, he changed the size and shape of the bag until the entire filtration process took less than 10 minutes.
Once the bag's design was perfected, he raised $250,000 from family and friends and began production. Then came the task of convincing medical professionals to try the device.
The UConn Health Center in Farmington began using the Hemobag more than a year ago.
One of the first institutions to use the device was Salem Hospital in Salem, Ore.
"We've used over 800 Hemobags," said Scott Beckmann, one of the hospital's perfusionists. "We're using less blood bank products. That's been a cost savings for the hospital."
Before Salem Hospital began using the device, "We used cell washers that would wash away significant and beneficial blood elements and would only give back red blood cells — red blood cells are important, but that's not all there is to it," Beckmann said. "Ethically, we would look at this waste bag full of viable elements — proteins, platelets that help plug that hole in the artery — and it was being thrown out.
"When the Hemobag was finally made available, we sat down with the surgeons and said, 'This looks like a helpful device.' We said 'Let's try it for two weeks,' and before the two weeks were up, we decided to use it during every surgery."