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Research finds patch helps control bleeding

by Dawn Brazell
Public Relations
Discoveries can come from the most unusual of places.
Just ask John Vournakis, Ph.D., vice president of research and development for Marine Polymer Technologies Inc. and professor of graduate studies at MUSC. In the early 1990s, Vournakis was a researcher and faculty member at Dartmouth College when a colleague from the Massachusetts Institute of Technology and an expert in marine organisms, Dr. E.R. Pariser, contacted him about a unique marine microalgal organism, also known as a diatom.
“What he showed me was a picture of this organism with these fibers coming out of its ends. He said, ‘John, I think you should study these things. These things are interesting.’ That’s how I got started. It was that simple.”
Vournakis found a Maine laboratory where he could buy a culture of the organism. He learned how to grow mass quantities of the diatom in the laboratory, then isolate the fibers and make a material that could be used to control bleeding. The discovery led Vournakis, Pariser and their colleagues to set up Marine Polymer Technologies Inc., a privately-held company that researches, develops and markets technologies based on this microalgal-based polymer that accelerates the body’s hemostatic processes.
The product, named the SyvekPatch, received approval from the Food and Drug Administration in 1999 to be used to control bleeding from vascular access sites and catheters in cardiology procedures. Vournakis said the product now is widely used nationally to control bleeding in trauma and surgery.
“We were very fortunate that we made a discovery that has turned out to be quite useful.”
Vournakis next wanted to know if this technology could be helpful for dialysis patients. He made contact with state Medicaid authorities and with David Ploth, M.D., who oversees a number of MUSC research projects, to set up a study using Medicaid patients in dialysis clinics, with the cost of the product being reimbursed by the state.
The local study, published September 2009 in The American Journal of the Medical Sciences,  was done from January 2001 to December 2005 at outpatient hemodialysis centers in Charleston with the population more than 80 percent African-American. Done in conjunction with researchers at Johns Hopkins University who analyzed the data, the study found that patients who used the patch had a 60 percent reduced probability of having a failed access site and that their bleeding was easier to control.
Vournakis was thrilled at the results, and is excited about future research. He explains that the product is not a drug and the material does not dissolve or go into the bloodstream, but rather acts as a surface catalyst on which red blood cells and platelets act in concert to form a clot.
“If you look at the SyvekPatch with a high-powered microscope, what you’ll see are these long fibers all criss crossing. It’s like the Los Angeles highway system. If you look at it from above, you’ll see these criss-crossing roads. That’s what the blood sees. When you put this down, platelets and red blood cells interact directly with these fibers. When that happens, a process takes place we call activation. That leads to the initiation of the clotting cascade.”
Caroline Counts, a registered nurse at MUSC and co-author of the study, said the research examined whether the patch could preserve the life of the graft or fistula at the access sites and minimize blood loss.
“I thought it really was a miraculous thing in how it promotes healing.”
Counts, who is research coordinator in MUSC’s Division of Nephrology, said patients in the study liked that it shortened their time in the clinic because of its ability to control bleeding.
“It’s really their lifeline,” she said about the two access sites needed for dialysis. “It’s how they get connected to this dialysis machine. We started using the patch, and we went back and looked at how many times they got the site infected or the access clotted off. All of those things can require surgery for the patient. From an economic standpoint, it can get very expensive, even the IV antibiotics that are used to treat infection.”
Vournakis, who hopes to see funding approved for the use of these patches for Medicaid and Medicare patients, said there are about 350,000 patients on dialysis, with more than 90 percent of them on Medicaid. Dialysis requires going into a clinic three days a week for several hours, so it’s a costly procedure, particularly for those who require emergency treatment because their bleeding can’t be controlled.
“It’s a huge astronomical number. It’s the No. 1 cost item for Medicare and Medicaid. A large part of that cost is to pay for these repairs,” he said.

Friday, April 16, 2010

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