In the beginning was Arenicola marina, the sandworm.

If it is not seen often, because it prefers to hide under the sand, any visitor to the beaches of the Atlantic and the English Channel has already seen the twists that it leaves behind, on the surface.

To say that it is not very young is an understatement, this worm is some 450 million years old.

This gives him an organism that is resistant to say the least.

The creature indeed knows how to remain crouched without oxygen, waiting for the return of the high tide, for several hours.

Twists left by a lugworm on a beach in Saint-Jean-du-Doigt, May 25, 2022 in Finistère FRED TANNEAU AFP

And this is thanks to its hemoglobin, close to human hemoglobin, but more efficient, each molecule being able to fix 40 times more oxygen than its human version, explains Franck Zal, the boss of the company, in the laboratories in Morlaix.

A quality that society uses to allow oxygenation of grafts during organ transplants.

In one of the freezers, almost 300 kilos of worms are kept, in bags of one liter each.

The worms, a few centimeters long, seem innocuous, far from operating rooms.

They will then be thawed, which will cause hemorrhagic shock.

FRED TANNEAU AFP

The hemoglobin molecule will still go through several processes before being transformed into a small 1 gram vial of a dark red liquid.

Industrialization complex

This solution will then be added to the graft preservation fluid, pending transplantation.

250 kilos of worms represents 3 kilos of product, or 3,000 potential transplants.

From now on, it is mainly quality controls that take place here, the production having been entrusted to a pharmaceutical subcontractor with larger laboratories.

It wasn't easy, as worms are uncommon in the pharmaceutical industry.

A technician works on the hemoglobin of worms in a laboratory, on May 25, 2022 in Morlai, Finistère FRED TANNEAU AFP

"It was extremely complex to industrialize the whole process, with total traceability", explains Franck Zal.

“We started our research with a blender,” he recalls.

The former CNRS researcher first began testing on mice, filing a first patent in 2001, before founding Hemarina in the process.

The laboratory is now completing its second trial, on nearly 500 kidney transplant patients across France.

And he hopes to market his graft conservation product, called Hemo2Life, in the process.

If the data turns out to be positive, this could represent a major advance in the world of transplantation, explains Professor Yannick Le Meur, nephrologist at Brest hospital, who participated in the various trials.

"The big difficulty in transplantation is first of all the lack of grafts, with very long waiting lists", he underlines.

The authorities therefore had to broaden the acceptance criteria, with older donors, suffering from comorbidities, and ultimately grafts with a greater risk of dysfunction.

Hence the need to improve the conservation of these more fragile organs.

Easy to use

"We must prevent the graft from suffering and ensure that it can restart more quickly", explains the professor.

A first study has already given "encouraging results. We have shown a difference between the kidneys which had received the Hemarina solution, and those which had not received it: on the time it takes the graft to function after the transplant for example", explains the specialist.

A sample of hemoglobin from a arenicole worm in a laboratory in Morlaix, May 25, 2022 in Finistère FRED TANNEAU AFP

The hemoglobin of the worm worm "could have a major impact for the grafts, the patients, and also the habits of prescription and techniques", estimates Professor Le Meur.

A feeling shared by Professor Benoît Barrou, head of the medico-surgical kidney transplant service at the APHP, who is also taking part in the trial.

Faced with the lack of grafts, the specialist considers that Hemo2Life is "a revolution, in terms of ease of use and efficiency. Because in medicine, when something is developed, ease of use is decisive for its generalization.

Abroad too, Hemarina is beginning to convince.

In India last September, the Amrita Institute of Medical Sciences used its solution for a double upper limb transplant in a patient.

© 2022 AFP