In this issue
- Solvent Detergent Plasma Expanded Use
- Engaging with the medical community on Whole Blood, Leukocytes Reduced
- Our latest resources for transfusion professionals
- Treating iron deficiency with oral iron supplements: what is the best dosing frequency?
- Senior scientist wins prestigious award for discovering a ‘gold standard’ reagent used in transfusion medicine
- Commemorating Green Shirt Day
- New Canadian Blood Services plasma donor centres are opening in British Columbia and Ontario Spring 2023
Solvent Detergent Plasma Expanded Use
As of March 27, 2023, hospital customers were able to order solvent detergent plasma (Octaplasma) from Canadian Blood Services for all patient groups using the Canadian Blood Services Hospital Portal online ordering tool.
This is the start of Phase One for implementing pathogen-reduced frozen plasma. This phase involves the gradual six-month transition from Canadian Blood Services’ current Frozen Plasma inventory to Octaplasma. To support the transition, Canadian Blood Services will continue to have available an inventory of frozen plasma (approximately 20% of plasma issued at the end of Phase One).
Phase Two will involve process development and deployment of pathogen reduction technology for the remaining frozen plasma inventory using the Intercept Blood System for plasma. By the end of Phase Two, Canadian Blood Services’ frozen plasma will be entirely replaced with pathogen-reduced frozen plasma and will comprise 20% of total plasma inventory.
Canadian Blood Services has developed the following education materials to assist hospital customers with Octaplasma implementation:
- Frequently Asked Questions (FAQ)
- One page summary that can be printed by blood bank staff and provided with Octaplasma units when they are sent to the floor for transfusion
- Slide deck for clinical teams
- Slide deck for transfusion medicine laboratory technologists
- Video: Narrated presentation of slide deck for clinical teams
- Video: Narrated presentation of slide deck for medical laboratory technologists
Engaging with the medical community on Whole Blood, Leukocytes Reduced
In October 2022, Health Canada approved Whole Blood, Leukocytes Reduced to be manufactured and distributed by Canadian Blood Services for use by the Canadian Armed Forces. This product, alternatively known as Low-Titre Group O Whole Blood (LTOWB) or Leukoreduced Whole Blood (LRWB), has been the subject of renewed interest, in particular for the treatment of acutely bleeding trauma patients in near-hospital scenarios where standard component therapy is not available or practical. This has been based primarily on observational studies associating improved hemostasis with the delivery of cold stored whole blood which provides a fixed ratio of red blood cells, plasma, and platelets.
Most of the recent use of whole blood has been in the military trauma setting. However, it has also been adopted by some civilian trauma centres in the United States, and the use of whole blood has also begun to expand to the management of bleeding patients in non-trauma settings. However, despite this expanded usage, the evidence regarding clinical effectiveness is limited. Four recent systematic reviews, which identified a total of 21 controlled studies (in which 1,951 patients received whole blood), did not demonstrate a benefit for whole blood as compared to standard component therapy although no safety issues have been identified either.
Based on the current supporting data, Whole Blood, Leukocytes Reduced is currently available for military use only in Canada while a subcommittee of the National Advisory Committee (NAC) on Blood and Blood Products undertakes an assessment of potential non-military usage. Following ethics and stakeholder input, and taking into account pragmatic considerations regarding supply, the NAC subcommittee will provide specific recommendations for the introduction of whole blood, including clinical versus research use, patient groups (pediatric, trauma, surgical, and pre-hospital) and monitoring of outcomes (utilization, wastage, safety, effectiveness, impact on utilization of other blood products).
To support this work, the National Advisory Committee on Blood and Blood Products is interested in the perspectives of Canadian healthcare providers on the potential non-military use of Whole Blood, Leukocytes Reduced in Canada and is currently engaging with the physician community to understand current attitudes and insights towards this product. To facilitate this work, medical professionals are encouraged to visit the whole blood engagement website and fill out the accompanying survey:
The survey is open until April 30th, 2023, and all are encouraged to share their perspectives.
Our latest resources for transfusion professionals
Canadian Blood Services develops educational resources on transfusion medicine and publishes them on its professional education website, a trusted source of information for health-care professionals across Canada.
Our latest resources equip hospitals with information and tools that promote best practices in transfusion medicine, particularly following recent changes implemented by Canadian Blood Services.
New resources now available
- FAQ: Solvent detergent (S/D) treated plasma (Octaplasma)
- Includes slide decks, narrated videos, and a printable one-page clinical summary
- FAQ: Whole blood, leukocytes reduced, at Canadian Blood Services
- The National Advisory Committee (NAC) on Blood and Blood Products is gathering the perspectives of Canadian health-care providers on non-military use of whole blood, leukocytes reduced in Canada. The online NAC survey closes April 30, 2023.
- FAQ: Donor high titre isohemagglutinin (anti-A/anti-B) testing at Canadian Blood Services
- Includes slide deck
- Clinical guide to transfusion, Chapter 19: pathogen-reduced platelets
- This new chapter in our clinical guide provides guidance on a new blood component manufactured by Canadian Blood Services: pathogen-reduced platelets. Additional resources include slide decks, narrated videos, and animations about the manufacturing process
- Clinical guide to transfusion, Chapter 14: Therapeutic apheresis
- The importance of iron for whole blood donors: a Canadian perspective
- Summary of adverse transfusion reactions 2017–2022
- Surveillance report 2021
Don’t forget our professional education website is also a great place to find out about upcoming events in transfusion medicine.
Do you have feedback on our educational resources? Please reach out through our feedback page. Or, if you plan to attend the Canadian Society for Transfusion Medicine 2023 conference in Montreal, drop by the Canadian Blood Services booth to share your feedback or ideas for new content. We’d love to hear from you!
Treating iron deficiency with oral iron supplements: what is the best dosing frequency?
Anemia, which affects approximately 33% of the world’s population, occurs when there is not enough hemoglobin in red blood cells to carry oxygen to the body’s tissues. Iron is a major component of hemoglobin, and iron deficiency anemia (IDA) is a condition that occurs when the body does not have enough iron to make healthy red blood cells. IDA affects 1–2% of males and 2–5% of females globally. Symptoms of IDA can include negative effects on physical and mental functioning, fatigue, weakness, hair loss, pica (where people have cravings for things not usually considered food, like ice and dirt), shortness of breath, and restless legs.
Taking oral iron supplements can help to improve the negative impacts of IDA. Oral iron–in the form of daily pills—is the recommended first line therapy in the management of IDA due to its ease of administration, wide availability, and low cost. However, approximately 30–70% of patients experience side effects when taking oral iron. These side effects can include constipation, nausea, vomiting, diarrhea, abdominal discomfort, heartburn, and headaches. Previous studies have found that taking oral iron supplements every other day (referred to as intermittent oral iron dosing) had a similar effect to daily oral iron dosing in terms of lowering the prevalence of anemia and increasing hemoglobin (a measurement of red blood cell levels). Interestingly, these studies found that intermittent dosing resulted in fewer side effects compared to daily dosing. We sought to explore this further through the DEODO study – “Daily vs. Every Other Day Oral iron supplementation in patients with iron deficiency anemia (DEODO): A pilot randomized controlled trial.”
Our results also showed that in both the daily and every other day (EOD) groups, fatigue improved and laboratory values, including hemoglobin and ferritin (a blood protein that stores iron and can be used to assess your body’s iron levels), increased; this means that participants had an increase in the levels of oxygen and iron in their blood from taking oral iron. We also found that there were no significant differences between the daily and EOD groups in terms of laboratory values, fatigue scores, or side effects. This suggests that oral iron treatment can be personalized, such that in the event of side effects, patients could potentially switch from daily to EOD dosing without being concerned that the treatment will be less effective.
You can learn more about the importance of iron in whole blood donors here.
Senior scientist wins prestigious award for discovering a ‘gold standard’ reagent used in transfusion medicine
Dr. Donald Branch, Canadian Blood Services senior scientist, has received four awards from the Association for the Advancement of Blood & Biotherapies (AABB) but his most recent honour as a recipient of the Dale A. Smith Memorial Award is the first time that comic book superheroes have played a part.
In 1979, Dr. Branch discovered a reagent which removes autoantibodies, allowing antibodies to be detected in situations when this would typically be challenging.
“You can make an argument that because of this reagent we might have saved some patients and reduced morbidity just because medical staff could clearly identify these other antibodies and then provide antigen-negative blood,” Dr. Branch said.
The reagent began its life known as S-SAP, an acronym referring to the biochemistry involved, but as researchers in the lab would hurriedly shout it out, it began to sound a bit more like “ZAP”. Over time it became impossible to resist the idea of the ray gun, that iconic sci-fi weapon portrayed in superhero comics everywhere, and so the reagent was renamed “ZZAP”.
Get the full story here.
Commemorating Green Shirt Day
Each year, April 7 is recognized across Canada as Green Shirt Day to honour, remember, and recognize all the victims and families of the fatal Humboldt Broncos bus crash and to continue the legacy of Logan Boulet by inspiring Canadians to register as organ and tissue donors and talk about the decision with their families. Logan became an organ and tissue donor in 2018 after his death as a result of injuries in the Humboldt Broncos bus crash. His organ and tissue donation saved or improved the lives of six people.
More than 4,000 Canadians are waiting for a lifesaving transplant and each year, approximately 250 people die waiting. You can make all the difference by registering to donate and talking to your family about your decision.
New Canadian Blood Services plasma donor centres are opening in British Columbia and Ontario Spring 2023
Three new Canadian Blood Services plasma donor centres will be opening this spring in Abbotsford, B.C., St. Catharines, Ont. and Vaughan, Ont.
Plasma donated at these plasma donor centres will be made into lifesaving medications for patients in Canada. Most of the plasma Canadian Blood Services collects at our dedicated plasma donor centres goes to manufacturers that make medications from plasma.
Immunoglobulins are the most widely used medications made from plasma. These lifesaving medications treat patients with immunodeficiency, autoimmune disorders and neurological disorders, among other medical conditions.
There is a global shortage of these medications and the plasma needed to make them, as these medications are in demand for a growing number of conditions. That’s why Canadian Blood Services is working to collect more plasma.
The new plasma donor centres can be found at the following locations:
- Abbotsford Plasma Donor Centre
- 32700 South Fraser Way, Abbotsford, B.C.
- St. Catharines Plasma Donor Centre
- 420 Vansickle Road, St. Catharines, Ont.
- Vaughan Plasma Donor Centre
- 200 Windflower Gate, Woodbridge, Ont.
To book a plasma donation appointment, download the GiveBlood app, call 1-888-2-DONATE (1-888-236-6283) or visit blood.ca.