Canadian Transfusion Trials Group recognizes influential clinical research with Paper of the Year award

The Canadian Transfusion Trials Group (CTTG) has announced the winner of their inaugural “Paper of the Year” award! The award was conferred April 24, 2026, during the network’s annual meeting held in Canmore, AB.

CTTG is a pan-Canadian network focused on accelerating the conduct of high-quality clinical trials to improve transfusion practice in Canada and beyond. Launched in 2023 with support from Canadian Blood Services, the network is entering its fourth year and continuing to grow.

This award has been created to recognize the peer-reviewed publications that describe a significant advancement in the field of transfusion science. It is presented to the first author annually.

And the 2026 recipient is....

Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery: The FARES-II Multicenter Randomized Clinical Trial

Dr. Keyvan Karkouti was acknowledged as the recipient of the award on behalf for the FARES-II Study Group, which included a team of more than 30 multidisciplinary researchers and transfusion medicine experts from spanning multiple countries. Dr. Karkouti is an expert in anesthesia, a faculty member at the University of Toronto, and has served as the Deputy Chief at Toronto General Hospital since 2011. He is cross-appointed to the Institute of Health Policy, Management, and Evaluation as well as the Interdepartmental Division of Critical Care Medicine.

This publication describes the clinical trial data in response to the question: Is prothrombin complex concentrate (PCC) efficacious and safe compared with frozen plasma for treatment of coagulopathic bleeding in cardiac surgery?

This question has impact to bleeding management practices because up to 15% of patients undergoing cardiac surgery experience excessive bleeding. Administering frozen plasma is currently the most commonly used therapy in these instances, but some studies – including the precursor pilot trial that led to the FARES-II investigations – have suggested that PCC may be more effective at treating bleeding without compromising patient safety.

Bleeding during cardiac surgery can be life-threatening and requires rapid, coordinated treatments. The FARES-II trial highlights the importance of replacing blood clotting factors with prothrombin complex concentrates over plasma transfusions.  What makes this study even more of a feat was the fact that it was conducted during surgical bleeding emergencies, setting the stage for future transfusion trials in cardiac surgery.

- Dr. Donald Arnold, CTTG co-director

Frozen plasma is distributed by Canadian Blood Services and requires both a blood group and thawing prior to administration. In addition, administering the plasma takes time as a typical dose has a very large volume of between 800-1200 mL, depending on the patient’s weight. Alternatively, PCC is a product derived from pooled plasma that contains a more concentrated formulation of four clotting factors that has undergone special treatments for pathogen reduction and can be stored at room temperature. There are logistical advantages to its use over frozen plasma, including the ease, speed, and volume of administration (typically less than 80 mL, depending on weight). There are two different types of PCCs available in Canada, and recommendations on their use are currently outlined by the National Advisory Committee on Blood and Blood Products (NAC).

Ultimately, the trial answered the question by finding that PCC was superior to frozen plasma in the management of excessive bleeding in patients undergoing cardiac surgery. It also found that patients who received PCC had fewer serious adverse events and acute kidney injuries compared to those who received frozen plasma. These findings are potentially practice changing for cardiac surgeons and cardiac anesthesiologists, and the healthcare provider teams that treat patients undergoing cardiac surgery.

Details on the trial’s findings, including resources to support implementation of the key takeaways are available as part of the Breakthroughs in blood webinar series on Canadian Blood Services’ professional education website, Profedu.ca.

• Breakthroughs in blood shares groundbreaking findings in blood research to promote best practices in transfusion. Hosted by Dr. Jeannie Callum, transfusion medicine specialist and hematologist at Kingston Health Sciences Centre, and coordinated by Canadian Blood Services, the webinar series delves into the “So what?” and “Now what?” of blood science and medical research with a focus on transfusion clinical trials and guidelines.

CTTG’s next call for Paper of the Year nominations is expected in late 2026, watch the CTTG website for updates.

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Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration. Find out more about our research impact.  

The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.