Hemotune

Magnetic Blood Filtration

Andrew Kuzemczak
February 25, 2025

Hi,

Welcome back to Future Human, and a special welcome to our 40 new subscribers since we started two weeks ago. This newsletter is rolling into triple digit territory! I got unreasonably excited when we crossed 100. You have to make a pitstop at 100 on your way to 1,000,000 is something my father always said (he never said that), but it is still a terrific milestone. Onward!

Some of you new subscribers will have noticed I released a survey feature that collects some information on you when you join Future Human. I appreciate you filling that out as it gives me a great view of who I am writing for. We will technically never know who the first ~75 subscribers are here, although I would venture to say its family and friends I pestered, so I will forever label you the ‘heavenly seventy’.

The survey has offered some sweet data in just the last few days. It appears so far we are:

70% MD or PhD candidates
15% physicians
5% startup founders
5% investors
5% project managers

We come from 9 different states and have some military representation from the Navy! At this stage those percentages and breakdowns are dictated by single digits of people, so let’s watch and see how it changes as Future Human grows, but exciting nonetheless.

Today’s edition is coming out at 1PM again. Last weeks A/B test showed me an afternoon release has similar results as a morning time. Additionally, further research tells me 8AM is too early for most (people replied and told me that). I am not married to 1PM on the dot, but I will be testing in the early afternoon timeframe over the coming weeks to see what works best. RIP 8AM.

This week, I am more excited than ever to write Future Human. Across our three editions so far, this is the closest we have come to science fiction, so let’s dive in.

For our new subscribers, often I like to use a car (our communal Ferrari) as an analogy for the human body. I feel it helps the finance types digest the science. Our Ferrari has upgraded its battery with Cairdac, swapped out its wheels and suspension with EpiBone, and now it looks to the oil. When our vehicle’s oil (blood) gets dirty (sick), we traditionally replace it (transfuse it). The question for the future then becomes:

If each Ferrari oil change was becoming more difficult to come by as well as risk prone, would you continue with this method or consider being the first to magnetically filter debris from what you currently have?

The Story

The practice of blood letting began 3000 years ago (hear me out, this won’t get weird). Although the idea now of bleeding someone out is insane, the concept in theory to remove toxins from their body via their blood is not. Many conditions such as intoxication, infection (sepsis), or autoimmune disease are manifestations of circulating disease-causing factors in the blood. The most immediate way to cure such conditions would actually be to remove the molecules out of the blood. Now although draining someone like they’re a pipe in winter is not the best course, selective removal of compounds (think bacteria, cytokines, and antibodies) could be effective.

A team working in the Functional Materials Lab at ETH Zurich confronted this and together spun off Hemotune.

Lukas Langenegger, a banker turned chemical/bioengineer, and Dr. Carlos Mora, a chemical engineer specialized in magnetic nanoparticles (a hint for where we are going), co-founded Hemotune in 2017. Eight years later and Hemotune is the leading startup in next-gen blood purification technology, and they are doing it with magnets, but nanoscopically small ones.

To be fair, hemodialysis exists. Since 1943, we have been pulling out blood through one needle and passing it through a dialyzer (artificial kidney) to filter out extra fluid, waste products (urea and creatinine), and excess salts before returning it through another needle. It is meant for patients whose kidneys are no longer functioning. We have not, however, been able to move beyond metabolic waste products or get very specific with what we remove. Imagine targeting removal of one protein, one antibody, or one cancer.

Lukas, Carlos, and the team at Hemotune are placing their eggs in this basket of specificity, and they are beginning with sepsis as their beachhead. Makes sense as few diseases hit the system so hard. Let me explain.

Ill keep it brief since “The Sick” and “The Economy” sections will hash this out more.

Sepsis is a deadly complication of bodily infection.
Chemicals are released into the blood to fight the infection, but these chemicals trigger inflammation which wildly overreacts.
This inflammation damages organs and can lead to multiple organ failure.

Get it? Got it? Good!

One in five deaths globally are sepsis related. That is 11+ million people. Hemotune believes if we can advance filtration to target such infectious and inflammatory compounds, we can save countless lives and cultivate a market. They just might be on to something.

The Tech

This next part sort of blew my mind. For context, I first discovered Hemotune last summer when writing a 30in30 series on LinkedIn. I barely believed it then and still can’t wrap my head around it. Feels like some Tony Stark level work to have nanoparticles cleaning your blood extracorporeally and then returning it without any toxins.

The Hemotune tech is built on a few insane pillars

Magnetic Sorbent Beads (HemoBeads) — contain a magnetic core with a non-adhesive polymer coating and affinity binders that only attach to the desired compound. These binders can be swapped to target new compounds.
Purification Device (HemoDevice) — like a dialysis machine, but instead of a filter diaphragm this device mixes the beads with the blood to bind target toxins. Fresh beads are continuously added, avoiding saturation.
Separation Stage — the mixture moves through a magnetic cartridge where the beads+bound compounds are removed and the clean blood returns to the patient without any beads (obviously — Marvel already trademarked Magneto).

Hemotune’s HemoSystem Render

This is health and tech at its most incredible. These are the collision diamonds I have spoken about.

The beads are 300 times smaller than red blood cells, which had me initially questioning how they do not damage the surrounding cells and epithelia. I imagine moving with enough velocity, they would pierce something. The company was way ahead of me.

The company has published a bunch about their work and about the power of ferromagnetic encapsulated nanoparticles interacting with the cells and compounds. Put simply, they found no signs of damage to surrounding cells, but did note that too much exposure and shear stress drives uptake of the nanoparticles by endothelial cells. By modifying that time in blood, the team is better able to eliminate unwanted uptake.

As a note, I have been requested by our most nerdy bunch to add in-text citations in the future for academic publications I mention which is totally fair. I am working on having all sources cited in text with direct hyperlinks, but forgive me I have not solved the puzzle yet for this edition. For now, these papers are #3 and #4 below.

So there you have it. Just some nanoscopic magnets binding to exactly one type of toxin and pulling them from the oil of your life to keep you running clean. Sci…fi…stuff.

The Market

The global blood purification equipment market is much larger than even I expected, like $20 billion in 2023 large and growing at 5% per year.

I know what some of you are thinking…that’s a market?

Amazingly, it is and its mainly dominated by dialysis. Kidney related filtration consumes >60% of the market and with chronic kidney disease (CKD) and end-stage renal disease (ESRD) becoming more prevalent, that percent won’t be changing soon.

What I find much more important for Hemotune, however, is the sepsis market. Although smaller in absolute terms, sepsis is growing much quicker with a CAGR of 7-10% depending on which report I entertain myself with. Now I know these analyst reports are notoriously inaccurate, so we shouldn’t obsess over the specific numbers. That said, when combining 2-3 reports and getting a general idea of the market direction, I think we can assign the comparison some value. Whether its 5%, 6%, or 8% is less important than the fact that sepsis is always rated as growing much faster than blood purification more generally.

This beachhead market is also agreeable with investors. Hemotune closed a $15.5 million Series B round in March of 2024 led by Belmondo. Existing investors staying on included VP Venture Partners, HEMEX, OCCIDENT, Zürcher Kantonalbank. EFI was the new group at the table.

The blood purification market, as mentioned above, is dominated by renal filtration devices. Septic filtration is practically not an option technologically (yet), but my research did lead me through a lot of septic plumbing systems. Within renal filtration, the leading player bar none is Fresenius Medical Care, a German multinational health care company famous for dialysis device development and center management. Although this $30B incumbent continues to innovate across blood filtration, they remain squarely in kidney function. Each PR announcement I read going back 5 years is just a new way to support kidney function, or take it over completely. They do not seem to have an interest in filtration outside of CKD, so Hemotune may just be clear for takeoff.

TLDR; market is growing, Hemotune chose a great and expanding niche in sepsis, and the incumbents should probably leave them alone.

The Sick

Lets begin this time with the patients by reiterating — sepsis moves quick. The trigger inflammatory response can lead to organ dysfunction, shock, and death within hours. What does that really mean in more relatable terms you ask? Imagine you run a flat tire on your Ferrari, and before you can finish saying “I got a flat!” your airbags deploy, engine explodes, and car overturns.

Sepsis moves fast.

The risk of death increases by 7.6% for every hour that passes without treatment. Septic shock is the most severe stage of sepsis, and 30-40% of people with septic shock will die, even with treatment. For all these reasons, sepsis is heavily researched in the emergency room and beyond for how best to approach it (even if we don’t understand why it happens).

We know that four types of infections are more likely to lead to sepsis:

Lung infections like pneumonia or COVID-19 —> 33%
UTIs, bladder, and kidney infections —> 25%
Skin infections like MRSA —> 10%
Gut infections —> 10%

We also know that it impacts the oldest and youngest patients, and those with a weakened immune system. It kills more people than almost any other disease, targets our most vulnerable, and yet we still don’t have much of an effective approach to it. Currently we use broad spectrum antibiotics IV to combat the infection, offer fluids to balance the blood pressure, and add some oxygen to support breathing but besides that and some prayers we let the body do its thing.

What if we could soon do more?

Like dialysis for a CKD patient, Hemotune’s HemoSystem could become the most incredible sidekick for the hero in need (back with the superhero references!). Connecting patients to this filter to alleviate the bodily burden of handling the infection and inflammation alone could be transformative.

And as exciting as sepsis is, there is so much more Hemotune could expand into! More on that below.

The Economy

Ohhhhh the economy. This is quickly becoming my favorite section to write. I know its a bit odd for a med student to care about this, but that is what I hope differentiates Future Human from other blogs and newsletters in the health or tech space. Also, I’m writing this from within the borders of the USA, so the money matters. Like it or not, it’s what we got.

In the United States alone, direct sepsis costs are approaching $40 billion annually. It stands as the most expensive condition treated in hospitals. I frankly did not believe this until I dove further.

Internationally, the average cost of treating a sepsis patient in high-income countries exceeds $32,000 per case. Nations are spending anywhere from $20,000 to $55,000 per septic patient. In a recent meta-analysis considering 26 sepsis studies, researchers found that sepsis was costing nations globally an average of $52 per person per year (reference #10 below). Put another way, countries spent 2.65% of their healthcare budget on sepsis, which equals 0.33% of their GDP on average on the disease.

Since I imagine many are wondering, the high cost of sepsis treatment is attributed to extended hospital stays, intensive care requirements, need for multiple medications, and potential complications arising from organ dysfunction.

To state the obvious, these are staggering numbers. One disease, which lacks its own diagnostic test and specific technological intervention, costs us 0.33% of all goods and services we produce as a nation. Something more must be done. Our oil is getting filthy. Someone or something must intervene.

My Thoughts

I have waxed on about blood purification, sepsis, and Hemotune’s potential for 2,163 words so far, so I will keep this short.

Lukas and Dr. Mora’s work at Hemotune could be life saving for millions worldwide each year. More must be done for sepsis and this could be the leap. I hope I have made that clear.

What I am just as excited about are the possibilities and applications outside of sepsis. Could we one day collect blood that normally would not be viable for donation and filter it to a healthy baseline? Could we transfuse blood between subjects that are not a perfect match, but use magnetic filtration to match the blood compositions? Could blood banks modify their stores to what is most needed?

All a dream at this point, but one we are that much closer to because of the team at Hemotune. Thank you to them!

To more lives saved,

Andrew

I always appreciate feedback, questions, and conversation. Feel free to reach out on LinkedIn @andrewkuzemczak.