|Research finds patch helps control bleeding
by Dawn Brazell
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
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,”
Friday, April 16, 2010