Hospital Newsletter

Ongoing immunoglobulin share split monitoring

Ongoing immunoglobulin share split monitoring (PDF)

As previously communicated by the National Emergency Blood Management Committee (NEBMC) last fall and in customer letter 2020-50, the security of immunoglobulin (Ig) products (IVIg and SCIg) supply had become a global concern. Canadian Blood Services anticipated shortages of select vial sizes and brands of IVIG, and we asked our hospital customers to assist us with mitigating the situation by making minor adjustments to the share splits of the various IVIG products that they transfuse.

“We continue to monitor the situation closely,” says Sarah Jennings, associate director, plasma protein and related products at Canadian Blood Services. “We sincerely thank our hospital customers for their ongoing support and collaboration.”

The share split adjustments and hospital customer collaboration have allowed Canadian Blood Services to continue to meet patient needs. Our team continues to send regular Ig share split reports and, we are encouraging all hospital customers to check them routinely.

To read more articles, please visit the BloodNotes section of blood.ca.

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Tracking unexpected passive anti-D in donors

Tracking unexpected passive anti-D in donors (PDF)

As part of our routine screening, donors are asked whether they have been pregnant in the last six months and whether they have received a blood product in the past. Their response to these questions could determine whether they can donate blood products in the future. Also, because anti-D from Rh immune globulin administration is considered transient and not clinically significant, it’s important to know whether a detected anti-D in that donor is passive or immune.

However, some donors unintentionally provide incorrect answers to their pre-screening questions. For example, Canadian Blood Services have seen donors who received Rh immune globulin; yet, not all of them understand that an Rh immune globulin injection constitutes receipt of a blood product. Also, when asked the donor screening questions, not all donors consider a miscarriage or spontaneous abortion to be a pregnancy.

Providing accurate answers to these questions is important because an immune anti-D or a passive anti-D that is not “recognized” as passive, will lead to permanently denying the donor the opportunity to donate plasma for fractionation or transfusion. Hence, we will never be able to use that donor’s plasma or platelets. That’s why making the distinction and identifying a passive anti-D has a significant impact on the subsequent use of blood products from the donor.

We often detect and suspect passive anti-D when we identify new anti-D antibodies in donors who are young women, and these antibodies are usually weakly reactive — 2+ or weaker. In these cases, the donor information is sent to our medical office nursing team, who follows up with the donor to determine whether they may have lost a pregnancy or needed to receive Rh immune globulin. In many cases, they have, and so we know that this was an omission at the time of donor screening.

We cannot easily follow up with physicians, as these are donors, not patients. Also, we don’t contact physicians without first discussing with the donor. However, Canadian Blood Services is exploring process changes that would help prevent this omission in the future. We are also exploring potential changes to the questions in the donor questionnaire to help women donors understand those questions and ensure that they answer them correctly.

How can you help? We hope that by highlighting this challenge, patient consent and notification processes could be enhanced to state that Rh immune globulin is a blood product. This might improve the accuracy of our donors’ questionnaire responses.

To read more articles, please visit the BloodNotes section of blood.ca

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How the NEBMC collaborated with stakeholders to mitigate blood shortages during the pandemic

How the NEBMC collaborated with stakeholders to mitigate blood shortages during the pandemic (PDF)

The COVID-19 pandemic has been a test of Canada’s blood shortages planning framework. The impacts of the pandemic on blood supply and the planning that followed are described in a recent article published in Transfusion.

Canadian Blood Services experienced unanticipated, reduced blood donor collections because of the pandemic. However, after the National Emergency Blood Management Committee (NEBMC) — which meets regularly to review the supply of blood components and products during the pandemic and make inventory advisories — declared a “Green Phase Advisory”, our hospital customers “responded admirably by aggressively promoting restrictive transfusion practices and use of transfusion alternatives to mitigate negative impacts,” says Dr. Tanya Petraszko, one of the article’s authors and Canadian Blood Services director for medical laboratory and stem cell services.

The article highlights some of the steps that were taken by the NEBMC and stakeholders to mitigate blood shortages. One of those steps leveraged available posters from Choosing Wisely Canada to educate and promote restrictive red blood cell (RBC) transfusion policies. Clinicians and hospital administrators also used presentations to spread the word on the risk of blood shortages. In the end, the drop in blood donor collections was offset by a significantly greater reduction in demand than had been expected. Consequently, blood supply remained sufficient to meet demand.

Thanks to the sustained communication and collaboration of the NEBMC with jurisdictional partners and national patient care organizations, we succeeded in mitigating a shortage.

To read more articles, please visit the BloodNotes section of blood.ca

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New plasma protein and related products warehouse opens in Calgary

New plasma protein and related products warehouse opens in Calgary (PDF)

This fall, Canadian Blood Services will be opening a plasma protein and related products (PPRP) warehouse at its new Calgary operations facility. The organization is responsible for securing and providing plasma protein and related products to hospitals across Canada for use by clinicians and their patients in all provinces and territories — except Quebec.

Plasma — a protein-rich liquid in the blood that helps other blood components circulate throughout the body — is used as a raw material to produce drugs that can be used to treat conditions such as immune and bleeding disorders, and trauma and burn injuries.

Canadian Blood Services manages a pan-Canadian formulary of multiple brands of plasma protein products and synthetic alternatives called “related products.” With the launch of the warehouse in Calgary, western Canadian Blood Services sites will receive their weekly PPRP shipments from Calgary, and no longer from our Brampton operations warehouse site.

What this means is that the transit time for our weekly PPRP shipments for western Canadian Blood Services sites will be less. There will also be a shorter turnaround time for bulk replenishment. This will help to ensure our western sites have the target inventory levels of PPRP to fulfill hospital customer requests.

No changes will be made to the delivery dates and times for our distribution operations sites in Regina, Edmonton, and Vancouver. However, the day of the week our distribution site in Winnipeg receives PPRP will change, without any impact to our hospital customers.

To read more articles, please visit the BloodNotes section of blood.ca

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Stem cells without borders

Stem cells without borders (PDF)

When lockdown measures began rolling out across Canada at the beginning of the COVID-19 pandemic, some stem cell patients were in the middle of a process called conditioning, which typically includes intense chemotherapy and radiation to destroy their bone marrow prior to receiving a transplant. At that point, the patient is at risk of dying if the new stem cells are delayed. 

Faced suddenly with modified travel requirements, tighter border rules and fewer flights, the team at Canadian Blood Services Stem Cell Registry realized that connecting stem cell donors to waiting patients during a pandemic would require extra-heroic feats of logistics. 

Gail Morris, manager of donor services for the registry, shifted into overdrive and began assembling a cross-department network of colleagues whose responsibilities affected the transport of stem cells. The team reached out to relevant contacts in the federal government to ensure that international border closures would not restrict stem cell couriers’ ability to make their deliveries. After some logistics were ironed out, federal health officials acted quickly to permit pending courier deliveries to Canada.

The next step was to move beyond ad hoc arrangements and secure a permanent exemption from federal travel restrictions. The Canadian Blood Services team — in partnership with Héma-Québec, the operator of Quebec’s stem cell registry — worked with the federal government to clear a path for all stem cell couriers coming to Canada and permit them to depart again without quarantining in this country.

Read the incredible story of how our employees, donors and stem cell couriers stepped up to help deliver lifesaving stem cells to patients during the pandemic at blood.ca/stories.

To read more articles, please visit the BloodNotes section of blood.ca

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Canadian Blood Services furthers its commitment to plasma collection with the opening of Kelowna plasma donor centre

Canadian Blood Services furthers its commitment to plasma collection with the opening of Kelowna plasma donor centre (PDF)

This past June, Canadian Blood Services continued to boost plasma collections to meet patient needs with the opening of its dedicated plasma donor centre in Kelowna — the first of its kind in British Columbia.

Plasma is a protein-rich liquid in blood that helps other blood components circulate throughout the body. The proteins found in plasma are key to producing specialized medicines –– a need that is rapidly growing in Canada. These medications are used to treat patients with a variety of life-threatening conditions such as immune deficiency, bleeding disorders, liver diseases and many types of cancers.

The Kelowna plasma donor centre is the third dedicated plasma donor to open in Canada, following Sudbury, Ont. and Lethbridge, Alta., which opened in 2020. Canadian Blood Services’ new plasma donor centres are helping to increase source plasma collection and ensure patients in Canada have consistent and continued access to the plasma-derived medications they depend on.

While the new donor centre will be dedicated to plasma collection, there will be no change to how patients in Kelowna and the surrounding communities receive blood or blood products for their care. Opportunities to donate blood at mobile blood donor events will continue in communities outside of Kelowna.

Appointments to donate plasma are now available and donors can book their appointments by visiting blood.ca, downloading the GiveBlood app or calling 1-888-2DONATE.

To read more articles, please visit the BloodNotes section of blood.ca

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