Artificial Blood: A Potential Solution to the Global Blood Supply Issue

In recent years, you may have seen an increase in calls for blood donors, particularly for donations from Black and Mixed Heritage people. The dwindling blood supply and a lack of regular blood donations are global issues that health services around the world have struggled for years to solve. Scientists from Nara Medical University in Japan believe that they may have developed a solution - universal artificial blood. In this blog post, we explore the global blood supply issue and the science behind universal artificial blood.

The Global Blood Supply Issue

Image by Obi, from Unsplash

For decades, health services across the world have been noticing a decline in blood donation and blood stock levels. In England, the NHS has reported that the amount of blood available for emergency transfusions is critically low and has been since a cyber-attack on hospitals in London in July 2024. Analysis by NHS Blood and Transplant shows that around 2% of the English population are currently regular blood donors who help to keep the nation’s blood supply going. As you can imagine, many more are needed as the number of regular donors is falling by around 200,000 people per year. To maintain safe blood supply levels, NHS estimates suggest that over 5,000 donations are needed per day, which adds up to around 1.8 million donations a year.

This story is, unfortunately, not unique to England or even to the UK. In 2019, the first analysis of global blood supply and demand found that out of 195 countries, 119 (61%) did not have enough blood supply to meet demand (1). This included every single country in Central, Eastern, and Western sub-Saharan Africa as well as Oceania and South East Asia. Since then, not much has changed, and many countries are still facing major blood shortages.

The global blood supply largely relies on the goodwill of regular voluntary donors; however, despite numerous blood donation programmes and efforts to increase the recruitment and retention of donors, the number of these voluntary donations has been steadily declining. Over the years, researchers have identified a range of factors that may have contributed to this decrease in the global blood supply. These include:

• Climate change – studies suggest that climate change-related disruptions, such as extreme weather events and temperature fluctuations can impact blood collection, transport, and storage (2). People may be less able or likely to donate blood, and the blood that is collected may not last as long in storage. Climate change may also be increasing the demand for blood transfusions. People are more likely to get hurt and need transfusions as a result of extreme weather events such as flooding and tropical storms.

• Strict restrictions on eligibility criteria of blood donors – people could be prevented from donating blood due to things like recent travel and sexual history to minimise the spread of infection. In some countries, like the UK and, more recently, Australia, some of these blanket restrictions are being lifted to increase the number of eligible donors.

• Aging populations – health services usually accept blood donors aged between 18 and 65 (3). As the years go by and people live longer, the proportion of older adults over 65 years old grows, resulting in a smaller group of potential donors. Some researchers are pushing back against this age cap and advocating for older people to be able to continue donating blood as they age (3,4).

• Low public awareness and education about the importance of blood donation (5–7)

• Access to donation centres and lack of infrastructure to collect, test, and store blood safely (1,6)

•  Religious beliefs, cultural taboos, fear, and misconceptions about blood donation (5,6,8)

• The socio-economic status of potential donors – Research has found that rates of blood donation are higher in developed countries and that people with lower socio-economic statuses are less likely to donate blood (9).

Governments, scientists, and health services around the world have tried a number of approaches to help address the global blood supply issue, from exploring the use of stem cells to conducting research to identify the characteristics of people who donate blood regularly and putting out urgent appeals for blood donors. As the use of stem cells can be expensive and hard to scale up to large populations, and appeals for donors have not been as fruitful as global authorities may have hoped, more and more scientists have been embracing the idea of artificial blood as an alternative to voluntary donation.

Image by Aman Chaturvedi, from Unsplash

Artificial Blood: The Story So Far

Blood is composed of many different components and plays a crucial role in a wide range of processes in the body. This makes it hard to replicate; however, this has not stopped scientists from trying. Since the 17th century, researchers have been working to create the perfect artificial blood substitute.

One of the first types of viable artificial blood substitutes developed was a perfluorocarbon (PFC) emulsion called Fluosol-DA (10). It was developed by Green Cross Corporation in Osaka, Japan, and, when added to blood, it could carry around 34% of the oxygen content of normal blood. For over 20 years, Fluosol-DA was used to treat patients with severe gastrointestinal bleeding, anaemia, and vascular disease; however, it was eventually discontinued due to side effects. A number of other PFCs were created following the relative success of Fluosol-DA; however, none were able to pass clinical trials (10).

Attention soon shifted to the development of haemoglobin-based blood substitutes as they were closer to the make up of normal blood. Similarly to the PFCs-based attempts, various iterations of haemoglobin-based blood substitutes were developed; however, only a few of them have passed all stages of clinical trials (10).

In 2022, Professor Hiromi Sakai and his colleagues at the Nara Medical University in Japan carried out the first in-human trial of a new type of haemoglobin-based artificial blood substitute. This substitute was made up of haemoglobin vesicles (HbVs). HbVs are small hollow ‘balls’ around 225 – 285 nanometres in diameter. The vesicles are made up of phospholipid liposomes and contain a purified synthetic haemoglobin solution. As the vesicles do not have any blood type markers, they can be used as substitutes for all blood types. This led to the name ‘universal artificial blood’. In June 2025, Professor Hiromi Sakai and his colleagues began human clinical trials with this ‘universal artificial blood’. If this artificial blood is safe and does not have any harmful side effects, the researchers believe that hospitals across the world can begin using it as early as 2030. This would reduce the need for more volunteer donors with rarer blood types and could potentially save millions of lives.

Image by Charlie-Helen Robinson, from Pexels

What can we do?

While human clinical trials for artificial universal blood are ongoing, there are things that we can do as individuals to help tackle the blood donor problem. If you are able to, becoming a blood donor and donating blood when you can could help save a lot of lives. NHS Blood and Transplant reports that there is a critical need for donors of Black heritage, as we are more likely to have the specific blood types needed to treat sickle cell, a condition that primarily affects Black people. Around 50% of Black Caribbean and Black African people have a rare blood subtype called Ro. According to NHS Blood and Transplant, only 2% of regular donors have the Ro subtype; however, demand for Ro blood is increasing by 10-15% every year, leaving a huge gap between the number of donations and the amount of Ro blood that hospitals need.

As we covered earlier, there are some eligibility criteria that you need to meet to become a blood donor. Most people can give blood, but you can find out more information about who can and can’t donate blood on the NHS Blood and Transplant website. According to the World Health Organisation (WHO), blood donor eligibility criteria is broadly similar around the world, however we’d recommend checking national guidelines for full details as in the last few years many countries have begun changing some of their eligibility criteria and leaning towards individual donor assessments (IDAs), which allow for more people from LGBTQ+ communities to donate.

If you would like to start donating blood in England, you can find out more about how to become a donor and where your nearest donation centre is on the NHS Blood and Transplant website. To become a donor in other parts of the UK and around the world, please check the national blood service websites for the country you live in.

In conclusion, blood supply is dwindling around the world, and this can be particularly detrimental for Black people, as many of us have the rare Ro blood subtype. Scientists from the Nara Medical University in Japan believe they have developed a solution to tackle global blood shortages known as universal artificial blood. This synthetic blood could be used with all blood types and could potentially save millions of lives across the world. This new artificial blood is currently undergoing clinical trials. Until we know it is safe to use, there are ways that we as individuals can help. If you can, please sign up to become a donor and try to donate blood regularly.

By Esther Ansah, Blog Writer

References

1.      Roberts N, James S, Delaney M, Fitzmaurice C. The global need and availability of blood products: a modelling study. Lancet Haematol. 2019 Dec 1;6(12):e606–15.

2.      Viennet E, Dean MM, Kircher J, Leder K, Guo Y, Jones P, et al. Blood under pressure: how climate change threatens blood safety and supply chains. Lancet Planet Health. 2025 Apr 1;9(4):e304–13.

3.      Davison TE, Masser BM, Thorpe R. Growing evidence supports healthy older people continuing to donate blood into later life. Transfusion (Paris). 2019 Apr 1;59(4):1166–70.

4.      Hyde MK, Masser BM, Thorpe R, Philip AA, Salmon A, Scott TL, et al. Rethinking the role of older donors in a sustainable blood supply. Transfusion (Paris). 2025 Apr 1;65(4):758–66.

5.      Ashipala DO, Joel MH. Factors contributing to the low number of blood donors among employed residents in Oshatumba village, Namibia. Afr J Prim Health Care Fam Med. 2023;15(1):3680.

6.      Hanumantappa Talawar B, Havanoor PR, Kamatad SB. Barriers to Blood Donation: Identifying Deterrents in a Tertiary Care Setting. International Journal of Pharmaceutical and Clinical Research. 2024;16(12):1470–5.

7.      Pereira JR, Sousa CV e., De Matos EB, Rezende LBO, Bueno NX, Dias ÁM. To donate or not donate, that is the question: an analysis of the critical factors of blood donation. Cien Saude Colet. 2016 Aug 1;21(8):2475–84.

8.      Arshad M, Ellahi A, Ahmed F, Usman J, Khan SA. Blood Donation: Fears and Myths in Healthcare Workers of the Future. J Blood Med. 2024;15:487–93.

9.      Zucoloto ML, Gonçalez TT, Gilchrist PT, Custer B, McFarland W, Martinez EZ. Factors that contribute to blood donation behavior among primary healthcare users: A structural approach. Transfusion and Apheresis Science. 2019 Oct 1;58(5):663–8.

10.   Khan F, Singh K, Friedman MT. Artificial Blood: The History and Current Perspectives of Blood Substitutes. Discoveries. 2020 Mar 18;8(1):e104.