Research Units are summaries of the results and impacts of research conducted at, or in partnership with, Canadian Blood Services. Written by Canadian Blood Services researchers, in collaboration with the knowledge mobilization team, these summaries help with research dissemination and evidence-informed decision-making.

As CBS partners, MCTR researchers have been highlighted in Research Unit summaries. Below is a selection of Research Unit posts affiliated with MCTR researchers! 

A proposed mechanism for vaccine-induced thrombotic thrombocytopenia (VITT)

In this study, researchers from the McMaster Platelet Immunology Laboratory collected blood samples from patients exposed to either heparin or the AstraZeneca vaccine (since VITT mimics the response observed in patients with heparin-induced thrombocytopenia (HIT)). By comparing it with HIT, researchers found a proposed mechanism for platelet activation in VITT.

Treatment and detection of vaccine-induced thrombotic thrombocytopenia (VITT)

In this report, researchers describe the response to intravenous immune globulin (IVIG) in three patients, who were the first in Canada to be diagnosed with VITT after receiving the AstraZeneca COVID-19 vaccine. Researchers found administration of IVIG was associated with increased platelet counts in the three VITT patients. They also developed a new diagnostic test for VITT.

Platelet Transfusion in Children with Cancer

In this study, data was collected retrospectively for hospitalized children with cancer who received at least one platelet transfusion. Researchers found risk factors for poor platelet increment included older age, a higher pre-transfusion platelet count and ABO incompatible platelet with a longer storage duration. Repeated failure to achieve satisfactory responses to platelet transfusions was rare.

A more accurate and efficient way to manage blood demand and supply

In this study, researchers summarized the key challenges in blood inventory management and used historical data to show the need for a comprehensive approach for addressing these issues. Researchers showed that data-driven decision making can reduce hospital blood bank inventory and ordering frequency, leading to significant cost savings.

Perioperative treatment for patients with immune thrombocytopenia: Eltrombopag vs IVIG

In this study, researchers compared eltrombopag and IVIG for patients with immune thrombocytopenia (ITP) around the time of surgery in a randomized controlled trial. Researchers found that eltrombopag was not inferior to IVIG for increasing and maintaining platelet counts in patients with ITP during the perioperative period.

Protecting patients with sickle cell disease from alloimmunization risk: benefits of genotyping

In this study, researchers conducted a retrospective cohort study on 106 sickle cell disease patients in a tertiary care centre in Canada. Genotyping sickle cell disease patients provided clinically relevant transfusion information, such as variant alleles and rare predicted phenotypes, in addition to phenotyping.

Estimating hemophilia prevalence and life expectancy

In this study, researchers with the Data and Demographics Committee of the World Federation of Hemophilia applied new analytical approaches to national patient registries in six high-income countries to estimate the prevalence of hemophilia in men by type and severity.

Sex-mismatched red blood cell transfusions and mortality

This study summarized evidence from studies that examined the impact of sex-mismatched transfusions (when a patient receives a red blood cell transfusion from a donor of the opposite sex) on patient outcomes.

Plasma: what’s in the bag?

This study was designed to assess and compare three kinds of recovered plasma:
1) Recovered plasma produced by the buffy coat method and processed within 24 hours of collection;
2) Recovered plasma produced by the whole blood filtration method and processed within 48 hours of collection;
3) Recovered plasma produced by the whole blood filtration method and processed between 48 and 72 hours after collection.

Where is the blood going? Understanding red blood cell utilization to inform policies

In this study, researchers looked at worldwide red blood cell distribution from blood centres to hospitals over a span of five years, in order to provide the evidence that blood operators and hospitals need to make informed decisions in inventory management and transfusion practice.

Older blood as good as new: no harmful effects of storage time before transfusion

This study randomly assigned hospital patients who required transfusions to receive blood that had been stored for different lengths of time to determine whether the 42-day storage limit of red blood cells should be revised.

Supporting evidence to change regulations regarding the storage of cryosupernatant plasma

The study involved Cryosupernatant plasma units that could be spared without compromising national inventory levels. These units were removed from the supply chain, as an extension of quality control, and shipped Dr. William Sheffield’s laboratory in Hamilton. Because ABO blood type affects VWF levels in plasma, an equal number of units from type O donors and type A donors were tested.

The Canadian Blood Services Research, Education, and Discovery (R.E.D) Blog showcases work from CBS scientists and research partners, providing a brief snapshot of the project as well as the basic science behind it. From CBS: “Here we invite readers to explore the worlds of transfusion and transplantation science and learn more about how our research leads to improved everyday practices and ultimately – and most importantly – better outcomes for patients.”  Learn more about the R.E.D Blog.

As CBS partners, MCTR researchers have been highlighted in R.E.D Blog posts. Below is a selection of R.E.D Blog posts affiliated with MCTR researchers! 

Forecasting red blood cell demand: Improving ordering strategies in hospital blood banks

“Research from the McMaster Centre for Transfusion Research (MCTR) in collaboration with Canadian Blood Services proposes a new approach to ordering red blood cells—the most commonly transfused type of blood component— that could help hospital blood banks avoid over-ordering while still meeting patient demand. If implemented, the research team suggests this improved strategy for ordering decisions would lead to significant cost savings for healthcare systems and blood suppliers.”

Understanding a rare clotting disorder associated with some COVID-19 vaccines

“Discoveries made by a research team from McMaster University are providing vital information about a rare but sometimes fatal clotting reaction associated with COVID-19 vaccines that use adenovirus vectors…The team described the first cases of a new clotting disorder that has become known as vaccine-induced thrombotic thrombocytopenia, or VITT, in three Canadian patients who developed it after receiving the AstraZeneca vaccine. In a subsequent paper, the research team described the probable mechanism that causes clotting in these patients.”

IVIg alternative for surgery patients with bleeding disorder

“Patients with a bleeding disorder called immune thrombocytopenia (ITP) are at risk for blood loss if they need to have surgery. Because their blood doesn’t clot as it should, ITP patients are commonly treated before surgery with intravenous immune globulin (IVIg), which helps their blood clot by increasing the number of platelets. But a study published in The Lancet Haematology and led by Dr. Donald Arnold…shows that an oral medication…called eltrombopag is an effective alternative to IVIg for this patient group…”

Genotyping red blood cells can make transfusions safer for patients with sickle cell disease

“In a new study, a research team that includes experts from Canadian Blood Services and the McMaster Centre for Transfusion Research showed that genotyping red blood cell (RBC) proteins could help make transfusions safer for patients with sickle cell disease. Blood transfusions can be a life-saving treatment for patients with sickle cell disease…But transfusion comes with risks: if donor RBCs have proteins that are not found on the patient’s RBCs, the patient’s immune system attacks the donor’s foreign RBC proteins through a process called alloimmunization…”

Hemophilia’s global impact is greater than previously thought

“A new study suggests more men have hemophilia worldwide than previously thought and highlights the need for improved hemophilia care….Although it can’t be cured, hemophilia can be treated by injecting a patient with clotting factor concentrates to help restore clotting factor to normal levels. But treatment is expensive and may not be available to all patients, especially in lower-income countries…”

Does sex matter in red blood cell transfusions?

“When doctors select red blood cell units for transfusion into a patient, they consider the patient’s blood type to determine what types of donor blood would be compatible. What they don’t consider is the sex of the patient and whether the donor is the same (sex-matched) or different sex (sex-mismatched). But this may be a factor worth considering, according to a study led by Dr. Michelle Zeller…”

International researchers collaborate to understand trends in blood product use 

“Researchers at our Centre for Innovation are working with international colleagues to better understand the patterns of red blood cell distribution and use. Studies like these can help inform health-care providers worldwide about the optimal donor collection strategy and the distribution and use of O-negative blood products, reducing the risk of shortages in the future…”

What’s in a bag of plasma?

“Many plasma-derived drugs, including IVIg and coagulation factors, are essential, life-saving treatments. The steady increase in use of these drugs, in particular IVIg, is putting pressure on supply.  While source plasma remains the major source of plasma for fractionation, this study provides valuable information on what’s in a bag of recovered plasma…”