Blood clot expert Dr. Stephan Moll in the UNC School of Medicine said he was surprised and honored to receive a phone call directly from NASA asking for help.
NASA needed Moll’s immediate assistance because an astronaut aboard the International Space Station had a deep vein thrombosis, or blood clot, in the jugular vein of their neck. A member of the UNC Blood Research Center, Moll was consulted for his expertise and treatment experience of deep vein thrombosis on Earth.
The exact time frame of this situation and the identity of the astronaut is being kept confidential by NASA for the security of the astronaut.
This was the first known blood clot to occur in space. The proper way to treat it in the context of zero gravity is still unknown, and no data exists. There is a large lack of research on the matter, Moll said.
“A blood clot on Earth could be fatal, but at least there is access to emergency rooms and specific treatments for severe cases such as ‘clot busters’ that dissolve clots rapidly,” Moll said. “But in space, it becomes very risky.”
Moll said blood thinners on Earth cause a high danger for bleeding. And if a major bleed were to occur in space, they don’t have the reversal and medical support strategies that are available on Earth.
They had to proceed very carefully, he said. NASA could not transport Moll to the ISS in time, so he had to consult the astronaut and the NASA flight surgeons, the physicians who treat NASA astronauts while in space, solely through emails and phone calls.
“It was a nice intellectual exchange with them to come to a conclusion together as a group of experts as to how best to treat this astronaut,” he said. “This interesting situation with very unusual circumstances seemed to become more normal, as if I were speaking to a patient on Earth during a clinic visit.”
Shaneequa Vereen, a NASA public affairs officer, said NASA seeks expert input from outside specialists to pull together the best plan for the crew. She said NASA Flight Surgeons reach out to outside consultants in the same capacity as attending physicians in a hospital setting will consult a specialist, she said.
Moll said he helped decide that the best course of action was using blood thinners cautiously, and he advised them on what dosage and type to use and for how long.
Days before the astronaut’s return to Earth, Moll and the NASA Flight Surgeons realized the danger of the re-entry process. Moll helped advise the astronaut to stop taking the blood thinners before descending back home.
The astronaut made it safely back to Earth and needed no further medical attention for the blood clot.
“We have no idea what would have happened to that astronaut if the blood clot was not found,” Moll said. “If the blood clot had traveled through his bloodstream up to his brain, and if the blood was not able to flow out of his brain because of zero gravity, the clot could have severely expanded.”
Moll co-wrote a case study with his NASA counterparts on the successful treatment, which was published in the New England Journal of Medicine. He said he recently submitted a second publication about why this may occur in space, with respect to the developing process of screening astronaut space travel.
It is vital that more research is conducted on the topic, Moll said — not only for space missions, but also to help humans learn new things about how blood clots form on Earth.
Moll said he is still communicating with NASA, bouncing ideas back and forth about what kind of research could and should be done.
Moll is looking more into what this could mean for the future of space exploration and NASA's plans to eventually land humans on Mars.
It can take up to a year to travel to Mars and a year to travel back to Earth. If something bad were to happen in terms of a blood clot aboard such a mission, he said, these questions are critical.
“We need better understanding,” Moll said.
What the future of space exploration means for UNC
With the largest university-based nuclear physics lab in the nation and access to major telescopes worldwide, the College of Arts & Sciences’ physics and astronomy department is uncovering answers about the universe — including black holes, dark matter, supernovae and the evolution of habitable planets.
UNC Research has partnered with NASA on various research projects for years and will continue to do so.
UNC has long been a research partner with NASA for faraway planet discovery and analyzing distant planets, Nathan Blouin, director of UNC’s office of research development, said.
“We are feeling very excited about the plans our faculty are bringing up for future projects and directions,” Blouin said. “NASA is very much in the process of trying to align UNC Research with the next frontier of human exploration.”
Although NASA is not yet connected to the University’s biomedical research initiatives, Layla Dowdy, director of office of research communications, said that has large potential to change as NASA is planning to eventually travel to Mars and beyond.
Dowdy previously worked for NASA for years and served in multiple roles, such as public affairs specialist.
“We really try to demonstrate that we believe in the future of human and space exploration,” Blouin said. “Every aspect of UNC Research can apply to NASA’s missions, either in terms of exploration or aboard the ISS.”
Aligning with NASA’s priorities in space, Dowdy said there are experts around campus delving into topics such as radiation exposure, loneliness in space, blood flow of the human body in space and other physiological aspects that are essential to sustaining life.
“UNC’s connection to NASA is growing and it has always been there,” she said. “We’ve always had a relationship since the dawn of the space race in the ‘60s and we are now at the point where it will get bigger.”
And when NASA Day was held at UNC in November, Dowdy said NASA showed substantial interest and excitement in connecting with UNC students as possible future candidates. She said the agency brought their top-ranking officials to speak to students.
“NASA really sees the value in the opportunity here at UNC,” Dowdy said.
Boyette said the Morehead Planetarium recently partnered with the University of Minnesota on an educational project about the future of space travel related to NASA’s plans to land more people on the moon and eventually on Mars.
“It will take a lot of different people working together to ensure that people who are sent to space on these long journeys will remain safe and healthy,” Boyette said.
And UNC has many ways to help with that through various content areas and experts on campus, he said.
“The role that the Morehead Planetarium will play is to continue to educate the masses about the importance of space exploration,” Boyette said. “In the ‘60s, we had no idea that we would all have phones that connect to satellites — who knows what the future will hold?”