“Click Clotting” Technique Rapidly Creates Stronger Blood Clots

Researchers at McGill University have developed a rapid way to engineer blood clots that stop severe bleeding and support tissue healing more effectively. Their technique, called “click clotting,” links red blood cell surface proteins through a chemical reaction, resulting in a biocompatible clot that is 13 times more resistant to fracturing and four times more adhesive than natural blood clots. The team said the method could be used to develop life-saving biomaterials to help control severe bleeding, as well as benefit people with clotting disorders.

“Natural blood clots can be slow to form and mechanically fragile, which limits their ability to stop severe bleeding and can compromise healing,” said Jianyu Li, PhD, senior author and professor of mechanical engineering and Canada research chair in tissue repair and regeneration. “Our work shows that, when engineered appropriately, red blood cells can play a central structural role, enabling the design of stronger and more functional biomaterials.”

Senior and corresponding author Li, together with first author Shuaibing Jiang, PhD, reported on the development in Nature, in a paper titled “Engineering tough blood clots for rapid hemostasis and enhanced regeneration.” In their paper the team concluded, “Our strategy enables instantaneous clotting and markedly enhanced fracture resistance despite low structural polymer content, while preserving the intrinsic bioactivity of blood clots to enhance hemostasis and regeneration.”

Jiang, now a postdoctoral associate at Harvard Medical School, led the research during his PhD studies at McGill. Researchers at the University of British Columbia, the Medical College of Wisconsin, the University of Colorado Boulder, the University of Toronto and the research institute Versiti also contributed.

“Blood clots are pivotal for hemostasis and regeneration, but they are mechanically weak and form slowly, posing risks for life-threatening hemorrhage and limiting broader applications,” the authors wrote. “These limitations are attributed to complex coagulation cascades, abundant mechanically ineffective cells, and little structural polymers.”

Previous efforts to crosslink red blood cells (RBCs) have used chitosan, a polymer derived from crustacean shells, but these led to brittle clots, ruptured cells, and inconsistent clotting. In “click clotting,” the clot structure is fundamentally strengthened through a fast, bio-safe chemical reaction that connects proteins on the red blood cell surface, forming a solid gel in just five seconds. Because the “click” reaction doesn’t interfere with normal blood chemistry, it can work alongside the body’s natural clotting process. As a result, the artificial cell‑based gel, called a “cytogel,” can be added to whole blood, where it becomes embedded within the body’s own fibrin clot.

“Here we report a strategy that rapidly crosslinks red blood cells into tough cytogels and integrates them within blood clots,” the team further explained. “The resulting engineered blood clots (EBCs) form within seconds and exhibit a 13-fold increase in fracture toughness, and a 4-fold improvement in adhesion energy compared with native clots … Our strategy is advantageous over previously reported methods using chitosan to crosslink RBCs, which lead to brittle clots, hemolysis or inconsistent clotting.”

Li added, “The technology enables both autologous clots (using the patient’s own blood) and allogeneic clots (using type-matched donor blood). Autologous clots can be prepared in approximately 20 minutes, while allogeneic clots can be prepared within about 10 minutes. Given typical clinical time constraints, this approach has strong potential for in-patient emergency care, wound management and related settings.”

The team confirmed their results through in vitro testing, as well as through tests in rodents. “In vivo studies demonstrate that EBCs can rapidly halt hemorrhage, promote tissue regeneration, mitigate inflammation and foreign body reactions, and prevent postoperative adhesion,” the authors stated. Of particular note was effective healing and regeneration observed in the injured liver, with performance exceeding that of a clinically used product tested also tested as part of the study. “Compared with previously reported biomaterials for liver regeneration, EBC demonstrated milder inflammation and more efficient tissue regeneration,” the authors noted. Analyses showed minimal evidence of immune reactivity and no toxicity in major organs.

The researchers say that while further study is required before the cytogel can be used in clinical settings, the research establishes a foundation for its design and application.  “Overall, EBC, as a native scaffolding material, can promote tissue regeneration with minimal inflammation and foreign body responses, and prevent postoperative adhesions, outperforming the clinically used products,” the scientists concluded. “This work may motivate the development and translation of highly cellularized materials for bleeding control, wound management, tissue repair and regenerative medicine.”

“Engineered blood clots have strong potential for broad clinical use and could improve outcomes across many medical situations,” Li said.

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