Research Units

Transfusion of red blood cells (RBCs) is a life-saving procedure. However, transfusion is not without risk. In very rare cases, transfusion can cause an often fatal disease called Transfusion Associated Graft versus Host Disease (TA-GvHD). TA-GvHD occurs when donor white blood cells, transfused along with the RBCs, take up residence in the recipient’s body. The donor white blood cells sense that they are in an incompatible host and attempt to "reject" the recipient. To reduce the risk of TA-GvHD, RBCs are separated by centrifugation from the other portions of a whole blood donation and subsequently filtered to further remove white blood cells (leukoreduced).

Canada’s Special Forces operate in extreme conditions and dangerous environments. When a soldier is injured, blood is required, but transporting blood under battlefield conditions presents challenges. Blood products must be transported through extreme environmental conditions where they can be sent to battlefield locations by parachute descent followed by long distance treks (usually in the backpack of patrol soldiers) over rugged terrain in extreme environmental temperatures. The stress of these transport conditions may impact the quality of the blood products and potentially limit their clinical effectiveness or even have a negative clinical impact.

Hypoproliferative thrombocytopenia (HT) occurs when the production of blood platelets by the bone marrow is reduced. HT may occur in patients with leukemia, aplastic anemia or in cancer patients after chemotherapy. In patients with HT, platelets are transfused to increase the platelet count to prevent excessive bleeding. Immune system recognition of mismatches between the platelet donor and recipient can cause ineffective responses to platelet transfusion. Cross-matching platelets is a method of selecting compatible platelets for patients with HT, in particular, in hospitals where access to large panels of HLA-typed platelet donors is limited.

Hypoproliferative thrombocytopenia (HT) occurs when production of blood platelets by the bone marrow is reduced. HT may occur in patients with leukemia, aplastic anemia or in cancer patients after chemotherapy. In patients with HT, platelets are transfused to increase the platelet count to prevent excessive bleeding.

Platelets are normally thought to be the primary cellular mediators of hemostasis and can encounter a variety of inflammatory processes. For years, however, data has been accumulating that platelets may not only be exposed to inflammation but may also work to mediate it directly.

Canadian Blood Services is a not-for-profit organization whose mission is to manage the supply of blood and blood products in Canada, except for the Province of Québec. The majority of Canadian Blood Services activities involve collecting, producing, testing, and distributing transfusable products (red blood cells, plasma, and platelets). One of the products produced is cryosupernatant plasma which is made by removing the cryoprecipitate from slowly thawed frozen plasma. Most patients receiving cryosupernatant plasma suffer from thrombocytopenic thrombotic purpura (TTP), a disease in which ADAMTS13 (a plasma protein) fails to trim von Willebrand Factor (VWF, another plasma protein) to a size appropriate for healthy function.

Since the 1970s, Canadian regulatory standards have imposed a maximum shelf life of 42 days for red blood cells (RBC) to ensure quality of the transfused product. Recently, some studies have suggested that patients transfused with “older blood”, blood that is closer to outdating, may have a poorer health outcome.

Blood Operators, such as Canadian Blood Services, collect blood from donors with the goal to manufacture and distribute blood products to hospitals for use in patients in need. At Canadian Blood Services, red blood cell (RBC) units are the most common blood product distributed to hospitals. RBC units contain cells and biologicals that need to be stored under controlled temperature in order to maintain cell viability and limit bacterial growth. International regulatory agencies have established a “30-minute rule” to limit RBC exposure to uncontrolled temperatures during storage for up to 30 minutes to prevent contaminating bacteria from growing to lethal concentrations.

Canadian Blood Services is a not-for-profit organization whose mission is to manage the supply of blood and blood products in Canada, except for the Province of Québec. Canadian Blood Services tests every blood donation for known transmissible diseases, notably for HIV, hepatitis B and hepatitis C. At least two tests are done for each of these viruses to detect the genetic material (DNA or RNA) of the virus itself, as well as antibodies (the body makes these in response to a viral infection). However, if someone has been very recently infected, there is a period of time before their body will start to make antibodies, and even a few days or weeks before the amount of virus in the blood is high enough to be detected.

Canadian Blood Services is a not-for-profit organization whose mission is to manage the supply of blood and blood products in Canada, except for the Province of Québec. The majority of Canadian Blood Services activities relate to collection, production, testing, and distribution of transfusable products (red blood cells, plasma, and platelets). In recent years, to optimize its operations, Canadian Blood Services has looked at consolidating a number of its blood production and testing centres.