Our partnership with the Centre for Blood Research (CBR) at the University of British Columbia (UBC) is helping to train the next generation of researchers in transfusion science. This blog post highlights just some of the achievements in education, training or knowledge mobilization accomplished by CBR trainees.  

This is an abbreviated repost that originally appeared on the Centre for Blood Research blog in June 2024. It was written by trainees Joyce Teodoro (PhD student in the lab of Canadian Blood Services’ adjunct scientist Dr. Hongshen Ma) and Kiran Toor (Masters student at CBR in the lab of Dr. Brown), with edits provided by Kaitlyn Chuong (communications and programs coordinator at CBR).  

On April 18th, 2024, the Centre for Blood Research (CBR) held their 12th annual Norman Bethune Symposium, a renowned research event that gathers scientists, clinicians, healthcare professionals, and trainees to discuss advancements in the field of blood research. The symposium was held at UBC Robson Square, on the traditional territory of the Musqueam, Squamish and Tsleil-Waututh people. 

The full day event consisted of expert talks on thalassemia, thrombocytopenia, sickle cell disease, and other bleeding disorders. Research trainees delivered impressive presentations on innovative topics including engineering cells for cancer immunotherapy and computational approaches to inhibit Klebsiella pneumoniae. The event showcased nearly 30 trainee research posters, demonstrating the breadth of ongoing research. 

CBR Director, Dr. Ed Conway, began with the opening remarks, followed by the presentation by Dr. Christian Kastrup, Professor at the Medical College of Wisconsin and Senior Investigator at Versiti Blood Research Institute. Dr. Kastrup’s presentation focused on his work on genetically modifying transfusable donor platelets using mRNA-lipid nanoparticles. Following this, there were a series of presentations on the topic of bleeding disorders. It was a research-filled day that honored the contributions of Drs. Don Brooks and Dana Devine. 

Blood research & reflections 

The symposium was an amazing opportunity to learn about the exciting advances in blood research. It also served as a great platform for speakers to share their personal experiences with blood disorders, as well as for scientists to discuss their professional path in blood sciences. 

Attendees were fortunate to hear Ritika Rakshit share her personal journey with thalassemia, a genetic blood disorder characterized by the body’s inability to produce enough hemoglobin. She detailed her experience from being diagnosed to her treatment plans including being on extramedullary hematopoiesis (EMH) and switching to luspatercept. She offered insights into her hesitancy to switch medications and highlighted the invaluable support of her clinical team. Ritika continues to be an advocate for thalassemia in her role on the patient advocacy board. It was an eye-opening opportunity to be able to hear from a patient reflect on their own journey and understand their perspective on living with a blood disorder. 

Dr. Geraldine Walsh, a development scientist with Canadian Blood Services, also gave an insightful talk describing her career path in blood sciences. Drawing from her experiences, she shared several pieces of advice on navigating a career in science. She highlighted the importance of finding work that we are passionate about, building strong relationships, and learning from those around us. Dr. Walsh concluded her talk by encouraging attendees, especially research trainees, to explore various career opportunities, including those that may deviate from the conventional scientific career trajectory. 

Celebrating Drs. Don Brooks and Dana Devine 

One of the highlights of the symposium was the talk by Dr. Cedric Carter, which celebrated Drs. Don Brooks and Dana Devine’s achievements and contributions. Drs. Don Brooks and Dana Devine are two of the founding members of the Centre for Blood Research (CBR). In addition to their significant and impactful contributions to the field of transfusion science and medicine, they have been instrumental in promoting research and developing initiatives through various leadership roles. Dr. Brooks has served as Associate Vice-President, Research at UBC and Founding Director of UBC’s Support Programs to Advance Research Capacity (SPARC). He has also served as a member of the Board of Directors for TRIUMF, Provincial Health Services Authority, and BC Emergency Health Services. Dr. Devine has held numerous leadership positions, which include her role as chief scientist at Canadian Blood Services, director of the CBR, president of the Association for the Advancement of Blood and Biotherapies (AABB), and editor-in-chief of Vox Sanguinis, a transfusion medicine journal. Their dedication and commitment to scientific discovery through research and development serve as inspiration for future generations of scientists. 

Inaugural Don Brooks and Dana Devine Transfusion Science Innovation Address 

In honour of Drs. Don Brooks and Dana Devine’s scientific contributions to advancing transfusion science and medicine, the inaugural Don Brooks and Dana Devine Transfusion Science Innovation Address was presented by Dr. Stephen Withers. Dr. Withers, in collaboration with Dr. Jay Kizhakkedathu’s lab, worked on identifying efficient enzymes for cleaving terminal sugar structures on the surface of red blood cells (RBCs), which are responsible for determining blood types. By removing these terminal sugar structures, A and B type RBCs can be converted to the universal donor blood type O, which can increase blood supply for transfusion applications. By screening the human gut microbiome for enzymes that can cleave these terminal sugar structures, they identified a pair of enzymes (FpGalNAc deacetylase and FpGalactosaminidase) that can convert type A to type O blood.  

Posters & awards 

This year, there were 29 posters presented by various graduate trainees, postdoctoral fellows, clinical fellows and research associates! These included members within the CBR, but we also had the pleasure of having presenters come from out of town. Multiple trainees from the University of Alberta, University of Toronto & Queen’s University were able to attend the symposium with the support of the CBR Travel Award.  

The Best Poster Presentation went to Dr. Georgina Butler from the Overall Lab for their poster on “SARS-CoV-2 main protease 3CLpro (nsp5), regulates the formation of tunnelling nanotubes by coordinating cytoskeleton reorganization.”  

Our final speaker was Dr. Ed Pryzdial with an exciting talk on Dengue virus-induced thrombocytopenia. Afterwards, a reception was held and attendees got to network and socialize with each other to celebrate the end of another incredible symposium! 

A huge thank you to everyone who attended, to our speakers and all presenters! 

The Centre for Blood Research would like to thank their event sponsors, without whom the 12th Annual Norman Bethune Symposium would not have been possible: the Naiman-Vickars Endowment Fund, Canadian Blood Services, Novo Nordisk, GRIFOLS, CSL Behring, ALEXION, Sobi and Pfizer.  

Canadian Blood Services – Driving world-class innovation 

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. 

The Canadian Society for Transfusion Medicine (CSTM) annual conference, held in partnership with Canadian Blood Services and Héma-Québec, took place on May 23-26, 2024, in Saskatoon with the theme of “Bridging transfusion communities.” 

Coinciding with CSTM, Canadian Blood Services' annual Research Day also provided a chance for Canadian Blood Services’ extended research network to collaborate, share their research, and connect. We asked two Canadian Blood Services research trainees to reflect on their experiences and key learnings from these events. Read on for their perspectives! 

This blog was prepared by Mahsa Yazdanbakhsh, a PhD candidate in Dr. Jason Acker’s lab in Edmonton, and Carina Paredes, a PhD candidate in Dr. Sandra Ramirez-Arcos' lab in Ottawa. Mahsa and Carina are recipients of Canadian Blood Services Graduate Fellowship Program as well as travel bursaries to support their attendance at these events. 

1. You both contributed as planning committee members for Research Day 2024; why were you interested in contributing in this way?  

Carina:  

I volunteered for the Research Day organizing committee because I wanted to improve skills such as leadership and organizational abilities and because I believe that actively participating at Research Day is an opportunity for us [trainees] to engage in knowledge dissemination, networking and collaboration that will support our future careers!   

The best part of participating in this event was being an active part of the organizing committee and connecting with trainees, scientists, and managers, which provided me with a great opportunity to network.   

Mahsa:  

I contributed to Research Day 2024 as a planning committee member and moderated a session of presentations. My role involved organizing speaker sessions and supporting team communication. Having attended previous Research Days, I was eager to help enhance the event and being on the planning committee gave me a deeper appreciation for the effort involved while collaborating with a dedicated team. I learned valuable skills in event planning, teamwork, and problem-solving. Additionally, it expanded my network and allowed me to connect with many professionals at Canadian Blood Services.  

It's important for trainees to be involved because it offers leadership experience and fosters a greater connection to the academic community. 

2. Did you also share your research during Research Day and/or CSTM and if so, in what ways? 

Carina:  

I was selected for a Poster presentation at CSTM and I was also able to briefly present it at Research Day. My poster was titled “Role of the efflux pump NorB in survival and increased quinolone resistance of Staphylococcus aureus grown in platelet concentrates.” Staphylococcus aureus is a round-shaped bacterium that is naturally found in the skin and mucosa of healthy humans. It is important to study because contamination of blood components with this bacterium is a major safety threat to transfusion patients. My work aims to unravel the role of a specific gene in antibiotic resistance and virulence of Staphylococcus aureus when grown in platelet components.  

“Having this opportunity to present my work allowed me to receive feedback from peers and experts from different areas of the transfusion medicine. I find this aspect of presenting and sharing my work very important especially because the feedback received will direct me to improve my work and attain stronger research outcomes.” 

Mahsa:  

I presented my research during CSTM and Research Day through a poster and a rapid trainee presentation. My poster was titled, "Osmotic Variability in Red Blood Cells from Different Blood Donor Groups." A typical red blood cell’s lifespan is 120 days. This study compared how younger and older red blood cells from frequent and non-frequent blood donors respond to osmotic changes. Osmotic changes relate to the balance of fluid within a cell. Results showed significant differences in osmotic response among different donor groups, and these results may be useful for optimizing blood product quality and functionality. 

“Sharing research at these events provides an opportunity to disseminate findings to a broader audience within the transfusion community, which is important because the research contributes to existing knowledge in the field and has the potential to influence future research directions and clinical practice.”  

Overall, presenting at Canadian Blood Services’ Research Day and CSTM allows for collaboration, knowledge exchange, and advancements in the field of transfusion medicine, ultimately benefiting patients and health-care providers alike. 

3. How many times have you attended Research Day and CSTM and what was your favourite moment or takeaway this year?  

Carina: 

I attended Research Day and CSTM in 2023 and 2024. I really enjoyed every day of this event, but the highlight of this year was to visit the Vaccine and Infectious Disease Organization (VIDO) facilities in Saskatoon and learn more about their very interesting work. I was very pleased to listen to the keynote speakers at CSTM and their opening remarks. 

Mahsa:  

This marked my third participation in CSTM and second in Research Day, and the highlight was the reunion with familiar faces after a year! Meeting my close friend, whom I hadn't anticipated seeing at CSTM, was particularly delightful and added an extra layer of joy to the event for me. 

4. What would you say to other trainees about Research Day and/or CSTM? 

Carina:  

It’s a great opportunity for improvement and promotes learning, collaboration and innovation. It also allows us trainees to learn from each other's experiences, receive feedback from experts, and improve our individual performance. 

“I would say to other trainees: Participate, be present and get involved! As a trainee, it is important to not only present our research, but also to engage in organizational activities that will build our skill set for our future career.” 

Mahsa:  

I would encourage other trainees to actively participate in both Research Day and CSTM. Attending Research Day provides a platform to present your work and receive constructive feedback, while CSTM offers a broader networking opportunity within the transfusion community. These events offer opportunities for trainees in Canadian Blood Services’ research and education network to share research findings, receive feedback, and network with peers and experts. 

“By participating in these events, you not only contribute to the advancement of knowledge in transfusion medicine but also refine skills and establish connections that can be beneficial for your future endeavors.” 

Canadian Blood Services – Driving world-class innovation  

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.  

The Canadian Society for Transfusion Medicine (CSTM) annual conference, held in partnership with Canadian Blood Services and Héma-Québec, took place on May 23-26, 2024, in Saskatoon with the theme of “Bridging transfusion communities.”

Coinciding with CSTM, Canadian Blood Services' annual Research Day also provided a chance for Canadian Blood Services’ extended research network to collaborate, share their research, and connect. Following these events, we asked Canadian Blood Services research trainees to reflect on their experiences and key learnings from the event.

This blog was prepared by Poojan Joshi, a research assistant working with Canadian Blood Services social scientists Drs. Jennie Haw and Kelly Holloway.

What was it like attending your first Canadian Blood Services Research Day and CSTM conference as a research assistant? 

Attending CSTM 2024 for the first time (it was also my first conference ever!) as a social science research assistant was an incredible experience for many reasons. As I listened to the various presentations and engaged with experts in the field, I was struck by the vast array of knowledge and experience attendees brought to the field of transfusion medicine. I was also humbled by the multidisciplinary collaborations that go into building and maintaining an efficient blood system. 

My background includes training in social psychology and qualitative research methods from the University of Guelph, where I developed interest in areas such as health, immigration and refugees, public and media discourse and policy. In December 2022, I had the opportunity to work on a social science research project with Dr. Kelly Holloway and Dr. Jennie Haw titled “Addressing Systemic Barriers to Donation for Donors of African and South Asian Ancestry.” This project aligned very well with my research interests and underscored the importance of applying a broader sociocultural perspective to donation practices and research. I soon realized that my diverse interests were more connected than I had originally thought as I began to understand donation as a complex social act embedded in a wide sociocultural and political context. 

This understanding allowed me to view the presentations, posters, and plenary sessions of Research Day and CSTM 2024 through a social science lens. In doing so, I appreciated the impact that social science has on many aspects of the blood system, from donor to recipient, and the critical role it plays in addressing current and future complex challenges.

“Since joining Canadian Blood Services as a full-time research assistant in September 2023, I’ve gained a deeper understanding of the role of social science in transfusion medicine. 

Under the excellent mentorship of Drs. Kelly Holloway and Jennie Haw, I have developed a profound appreciation for the intersection of these fields and the critical insights social science can bring to transfusion medicine.” 

Thinking about Research Day specifically, what learnings or ideas have the presentations sparked for you?

Dr. Chantale Pambrun’s opening remarks highlighted the importance of the blood operator and how research plays a crucial role in improving transfusion medicine and health, as well as several challenges and opportunities ahead. One significant area where social science has played a key role is in donor policies and changes in deferral criteria. Dr. Mindy Goldman’s presentation noted that because donor policies impact blood safety, public perception, and product availability, a multidisciplinary approach is required to balance donor and recipient safety with the maintenance of an adequate supply.

Dr. Kelly Holloway’s presentation on the lived experiences of immunoglobulin recipients demonstrated the importance of incorporating patient stories to advance our understanding of health and inspire positive change. Immunoglobulin products (Ig) are manufactured from plasma and may be needed by patients with immunodeficiencies or autoimmune and alloimmune disorders. 

What was the most memorable moment from the CSTM 2024 program this year and what reflections did you take away from it?  

Dr. Jennie Haw’s presentation on the systemic barriers to blood donation experienced by donors of African and South Asian ancestry was memorable for me, as it illustrated the strengths and commitment of diverse communities in donating blood and plasma, highlighting the need to address the barriers they face. As I am actively involved in this project, it was powerful to see this perspective of social science shared with experts.

Another memorable session was the plenary on Indigenous health and well-being in Northern Saskatchewan. Presentations by Rena Sutherland, Janet Tootoosis, and Jack Janvier highlighted key considerations for transfusion medicine, such as trust, relationship-building, community engagement, and patient-centred care. They discussed the challenges of providing transfusions in remote areas and emphasized the importance of collaboration, expertise, resources, and clear communication.

The session also addressed the impact of colonialism, including residential schools, ongoing racism, and the exclusion of Indigenous holistic health views to provide guidance on effectively engaging Indigenous communities using a strengths-based approach. Social science research is crucial in these areas as it helps build and maintain trust through community engagement, ensuring inclusive and culturally safe care for donors and recipients. 

“My time at CSTM 2024 was more than just an academic exercise; it was a recognition of the inseparability of social science from the field of transfusion medicine. The talks and discussions illustrated how societal factors are connected to health outcomes and donor policies.”  

I am excited to carry this knowledge forward to the 2024 International Society of Blood Transfusion conference in June, where I hope to take my learning from a Canadian context and expand it by engaging with international experts in transfusion medicine. By fostering interdisciplinary collaborations and supporting innovative approaches, we can ensure that our blood systems not only operate efficiently but also resonate with the voices and needs of all communities.

Read more about social science and diversity in the blood system in these articles on blood.ca:

• Reducing barriers to blood donation in African, Caribbean and Black communities 
• Blood donors mean the world to many with sickle cell disease
• 5 areas a diverse donor base helps save lives (blood.ca) 

Canadian Blood Services – Driving world-class innovation 

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.  

Our partnership with the Centre for Blood Research (CBR) at the University of British Columbia is helping to train the next generation of researchers in transfusion science. This blog post highlights just some of the achievements in education, training or knowledge mobilization accomplished by CBR trainees.   

Canadian Blood Services 2024 Lay Science Writing Competition offered in partnership with the Centre for Blood Research (CBR) provides research trainees an opportunity to exercise and enhance their science communication skills by sharing their research with lay audiences. The competition was open to research trainees in the broad Canadian Blood Services research network – including trainees that are directly funded by Canadian Blood Services, in laboratories that receive funding from Canadian Blood Services, and at the Centre for Blood Research in Vancouver. In this blog, graduate student Mahsa Yazdanbakhsh, author of the third prize-winning entry, provides some behind-the-scenes insights into the preparation of her submission. The full entry text is also shared below.  

Why did you choose to participate in the competition this year?  

I chose to participate in the competition because it gave me a chance to highlight important research in neonatal blood transfusion, specifically focusing on umbilical cord blood (UCB) transfusions for extremely premature newborns. I saw this as an opportunity to show how UCB could improve survival and outcomes for these vulnerable babies. Since I’m involved in this research, I felt it was important to share my insights and the potential benefits this work could bring to neonatal medicine. 

The theme this year was “Connecting science with society”; what did this theme mean to you?  

The theme was particularly meaningful to me because it emphasizes the importance of making scientific discoveries accessible and relevant to the broader public. For me, it’s about bridging the gap between complex research and real-world applications that can improve lives. In our work on umbilical cord blood transfusions for premature infants, the potential benefits go beyond the laboratory—they directly impact vulnerable newborns. This theme reminded me that research is not just about advancing knowledge within the scientific community, but also about ensuring that society understands and benefits from these advancements. By participating in this competition, I aimed to contribute to this connection, demonstrating how science can address critical healthcare challenges and ultimately improve outcomes for neonates. 

Did the writing process help you learn or discover something new about your research?  

Yes, the writing process helped me gain a new perspective on our research. It required me to step back and think about how to explain complex scientific concepts in a way that is clear and relatable to a wider audience. This helped me see my work from a different angle, focusing not just on the technical aspects, but also on the broader impact it could have on neonatal care. Writing about my research also reinforced the importance of effective science communication, reminding me that research isn't just about what happens in the lab, but how it can be applied to make a real difference in society. 

What tips would you share with others who are writing about research for lay audiences?  

When writing about research for lay audiences, I recommend simplifying complex ideas without losing the essence of the work. Break down the concepts into clear and simple language, but ensure key details remain intact. I suggest focusing on why the research matters by connecting it to real-world applications or benefits, helping readers understand its relevance. Avoid jargon whenever possible, and if you need to use technical terms, explain them in an accessible way. I also recommend using relatable examples to make complex concepts easier to grasp. Present the research in an engaging way, perhaps by telling a story or highlighting its human impact. 

Read the prize-winning entry in its entirety below...  

Evaluating umbilical cord blood transfusion efficacy and safety in neonates 

Imagine a small infant who was born prematurely and is having a hard time surviving in the outside world. These extraordinarily early newborns, referred to as ELGANs (Extremely Low Gestational Age Newborns), are born before 28 weeks of pregnancy and must fight a losing battle against anemia, a disorder in which there are insufficient healthy red blood cells in their blood to carry oxygen throughout their bodies. A common strategy used by physicians to win this conflict is blood transfusions. These transfusions now depend on adult donors' blood. This method, while life-saving, has limitations. Adult blood cells might not always meet these delicate babies' unique needs, which could occasionally result in complications and less positive results. But what if there was a more efficient method? 

Umbilical cord blood (UCB) has been proposed as a treatment for anemia in infants in the past. Fetal hemoglobin (HbF), a particular type of hemoglobin that is beneficial at carrying oxygen and protecting cells from harm, is rich in UCB. The fragility of fetal red blood cells and low volumes presented practical challenges that led to a decline in the use of UCB, despite its promising results. However, scientists are now looking again at this overlooked hero. They think that the secret to safer and more efficient treatments for premature babies may lie with UCB. According to recent research, UCB may be able to supply the necessary transfusions, and ongoing clinical trials are examining its advantages over adult blood.    

How to store UCB is a big obstacle when using it. UCB has a shorter life span than adult blood, which can be kept in storage for longer periods of time. Scientists are actively working on new methods to freeze and store UCB so it can be readily available when needed. This process is known as cryopreservation. Our research team has developed a meticulous method to freeze and thaw UCB. This technique, involving the addition and removal of a substance called glycerol, aids in protecting the blood cells during the freezing process. Having demonstrated the effectiveness of this method with adult blood, we are now adapting it for UCB.   

Our research is guided by three primary objectives: optimizing the freezing process, minimizing immune reactions, and assessing survival rates. By refining our freezing and thawing methods, our aim is to ensure that UCB cells remain healthy and functional. Furthermore, we seek to compare how the immune system responds to UCB and adult blood to ascertain the safety and efficacy of UCB transfusions. Lastly, we will evaluate the survival of UCB cells after cryopreservation and thawing, comparing them to adult blood cells. Success in these endeavors could offer a more potent treatment for anemia in premature babies, leading to improved health outcomes and fewer complications, thereby revolutionizing neonatal care and providing these vulnerable recipients with a stronger start in life. 

In conclusion, our research in Dr. Jason Acker's lab on UCB aims to address the critical needs of premature infants by optimizing cryopreservation techniques, understanding immune responses, and comparing the efficacy of UCB to adult blood. The potential benefits of utilizing UCB are immense, and if successful, this work could transform the landscape of neonatal transfusions, offering these vulnerable babies a better chance at a healthy start in life. 

About the author:

Mahsa's research is supported by the Canadian Blood Services Graduate Fellowship Program award. In her work, Mahsa focuses on optimizing blood manufacturing methods and investigating how to improve the efficacy of blood transfusion.  

Canadian Blood Services – Driving world-class innovation  

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.  

Dr. John Blake is a research engineer at Canadian Blood Services and a Professor in the Department of Industrial Engineering at Dalhousie University. Based in Halifax, Nova Scotia, Dr. Blake and his trainees use engineering principles and various computer-based optimization techniques to inform large scale decisions at Canadian Blood Services.  

Applying network modelling to biologics  

To some, it may be surprising to learn that there is such opportunity to integrate engineering into the health-care focused setting of Canadian Blood Services. However, as Dr. Blake explains, the same engineering principles that apply to the development and quality assurance of other products also apply to biologics such as blood, stem cells and organs. One of these classic engineering approaches currently applied to improving operations at Canadian Blood Services is network modelling.  

Network modelling is a computer-based method that creates a virtual representation of objects and their relation to each other. The resulting models are particularly useful for maintaining adaptability in the collection of blood donations, as well as the distribution and inventory management strategies that allow Canadian Blood Services to remain a safe and reliable provider of life-saving products. 

Contributing to efficiency and sustainability in Canada’s Lifeline  

For Dr. Blake’s team, modelling is not about the data acquired but rather how they can turn existing data into real life change. Part of this approach is ensuring that Canadian Blood Services is asking the right questions when it comes to allocating resources. For example, Dr. Blake has worked on models to assess how changing stem cell donor recruitment will affect the number of matches for Canadian patients. By modelling things such as recruitment approaches, Dr. Blake’s work assists Canadian Blood Services to consistently identify ways to improve Canada’s Lifeline.

Recently, Dr. Blake has also been applying this method to optimize the number and location of mobile and permanent donor facilities across the nation. This redesign of the donation facility network will address the growing demand for donations by bringing Canadian Blood Services’ facilities closer to the donors. 

“I have waited my entire career for a problem of this type – it is truly a once in a lifetime opportunity.”

Dr. John Blake, Canadian Blood Services Research Engineer

Securing the future of Canada’s Lifeline  

To sustain a safe and effective blood system in Canada for years to come, network modelling and optimization is a never-ending process. This is one of the reasons that Dr. Blake is committed to securing the future of transfusion and transplantation systems by training and mentoring the next generation of engineers. In fact, seeing his former students join Canadian Blood Services and dedicate their talents to improving the future of Canada’s Lifeline is one of Dr. Blake’s proudest achievements.  

One of Dr. Blake’s former students, Matt Nelson, is now an industrial engineer at Canadian Blood Services.  

“In my role, I use systematic thinking to build and run complex models; collect and analyze the required data; produce useful results; and explain these results to non-technical leaders on a regular basis,” Matt says. Recently, Matt contributed to the launch and expansion of pathogen-reduced platelets, a new product that was implemented across Canadian Blood Services production sites starting in 2022. The implementation of pathogen-reduced platelets has provided an additional layer of safety for recipients by reducing the risk of potential transfusion-transmitted pathogens without compromising the quality of the component. Matt credited Dr. Blake in helping him develop the necessary skills he now dedicates to safeguarding Canada’s Lifeline:  

“Dr. Blake was the professor who introduced me to the uses of simulation to understand complex non-linear systems. This type of system is very common in situations that have a lot of variability – like the blood system – and simulation allows for exploration of the response of the system to changes.” 

Matt Nelson, Canadian Blood Services Industrial Engineer

Over the years, Dr. Blake’s ongoing modelling work and mentorship activities have also led to many recognitions and awards, but he is most proud of being recognized as Professor of the Year by Dalhousie Undergraduate students, and with awards for his contributions to the Canadian Operational Research Society. He has even the earned the distinction of being Dalhousie’s first engineer to be awarded grant funding from the tri-council agency, Social Sciences and Humanities Research Council (SSHRC). 

“I am proud to work on projects that have a measurable impact on people’s health and well-being,” Dr. Blake says. “I am forever grateful to Dr. Dana Devine for first giving me the opportunity to serve Canadians in this role at Canadian Blood Services.” 

Canadian Blood Services – Driving world-class innovation

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.  

As the Principal Investigator for the SexMatters trial described in this blog, Dr. Mickey Zeller is an Associate Professor in the Department of Medicine at McMaster University. She is also a Medical Officer at Canadian Blood Services. 

Around 2018, Dr. Mickey Zeller's grandmother asked her a question that she couldn’t fully answer at the time. It’s a question that Dr. Zeller continues to keep top-of-mind in her roles as an Associate Professor at McMaster University and a Medical Officer at Canadian Blood Services. Having sustained a pelvic fracture at the age of 94, she asked her granddaughter, “If I need a blood transfusion, could it come from a man... and if it does, would that be safe?”. As Dr. Zeller describes, “I looked at her and, in that moment, I said, ‘Grandma, no one knows! But it’s on my list to find out!’.” 

In fact, questions about whether selecting products based on the sex of donor and recipient could improve outcomes following blood transfusions have been around for years. However, there is not yet been enough evidence to definitively answer whether this strategy would help optimize hospital and blood operator practices.

After much perseverance, collaboration with researchers across Canadian Blood Services’ extended research network, and a successful bid for CIHR funding, a research team led by Dr. Zeller is embarking on a new research journey they hope will finally provide the evidence to answer questions about whether sex matters in red blood cell transfusion.

What will the study focus on and why is it needed?

When a patient requires a transfusion of red blood cells (RBCs), the matching of product to patient is based on compatibility testing that looks at whether the blood is group A, B, AB or O, whether it is Rh positive or negative, and what other antibodies are present. Canadian Blood Services’ Rare Blood Program also helps ensure patients with specific combinations of antigens – proteins that appear on the surface of red blood cells – can be matched with appropriate blood components. Laboratory studies on donor factors such as age and sex have looked at their impact on characteristics of RBCs in terms of hematocrit, cell volume, hemoglobin content, and deformability – that is, the flexibility or “squeeze-ability” of the cells. However, currently available evidence has not demonstrated a need for red blood cells for transfusion to be matched based on the sex of either donor or recipient. 

The principal research question being posed by this study is: In adults admitted to the ICU who require RBC transfusions, do donor-recipient sex-matched RBC transfusions result in improved 30-day mortality compared with sex-mismatched RBC transfusions? Answering this question has a large potential for impact because of the substantial number of blood transfusions that occur throughout Canada every year.  

“If there was a risk identified [from the sex of the donor and recipient], even moving the needle a little bit to improve the matching of blood product to recipient could add another layer of safety to current practices,” Dr. Zeller explains.  

What had to happen to make this study possible?

While it seems like a basic question to remain unanswered, Dr. Zeller acknowledges the investments of energy, expertise, and funding to get the study to this point.  

“Sometimes these basic questions remain for a long time because it is challenging to get the funding and infrastructure in place to be able to answer them in a scientifically rigorous way; even if they’re basic-level questions, it’s only by investing that you are able to gather the evidence to answer the question.” Dr. Zeller says.

That’s part of the reason why Canadian Blood Services’ investments in networks like CTTG are important. The Canadian Transfusion Trials Group (CTTG) is funded by Canadian Blood Services with the aim of supporting and accelerating clinical trials that can inform best practices in transfusion medicine in Canada. CTTG reviewed and endorsed this SexMatters study and provided support through its development, making it the second RCT since CTTG’s inception to earn CIHR funding following participation in their review process.

"I had the opportunity to present to CTTG twice and receive feedback that improved this study design and my application to CIHR for its funding. Having it reviewed by people like Dr. Donald Arnold, Dr. Jeannie Callum, Dr. Nadine Shehata – people with world-recognized expertise in this area – really led to the success of this application,” Dr. Zeller says. “We were able to have really rich discussions on tough questions about study design and impact, including details like how we would account for patients that are pre-transfused entering the study.”

Says Dr. Zeller, “Each time the application went through reviews, I could present to these colleagues to essentially say, 'Here are the criticisms it has received and here’s how I’ve handled them.' And they would provide me advice and encouragement to resubmit. It is really valuable having people across the country who are cheering for you, and who are hand-in-hand with you to celebrate your success!”

“It’s an absolute privilege to do high quality research because you have to be surrounded by an incredible group of humans. Academic curiosity and commitment by those that have mentored me have enabled me to do this work. It’s out of a generosity of spirit that people have shared their expertise with me for this work, and it takes a lot of time and effort.”

Dr. Mickey Zeller, Principal Investigator for the SexMatters trial

What other research has informed this study? 

Before this study received CIHR support, the research team undertook an exploratory analysis, a systematic review and meta-analysis, and a pilot trial which took place in 2022 across five Ontario-based hospitals to establish feasibility of the randomized controlled trial. Findings of retrospective observational studies indicated potential association between sex-mismatched transfusions and mortality, but some aspects remained unclear due to low certainty of evidence, inconsistencies or contradictory subgroup analyses in the available literature.  

Much previous research involving Canadian Blood Services researchers has also supported the need for this randomized controlled trial. This includes: 

• research undertaken in the lab of Canadian Blood Services Senior Scientist, Dr. Jason Acker, which has investigated impacts of various factors (including age and sex) on red blood cell storage and other factors of quality;  
• the iTADs clinical trial (short for “An innovative Trial Assessing Donor Sex on Recipient Mortality") undertaken by Canadian Blood Services Adjunct Scientist Dr. Dean Fergusson and colleagues that signalled there may be increased risks with blood from younger, female donors; 
• as well as research by Canadian Blood Services Adjunct Scientists Nancy Heddle and Dr. Donald Arnold at McMaster University’s Michael G. DeGroote Centre for Transfusion Research (formerly known as the McMaster Centre for Transfusion Research) which was supported through Canadian Blood Services’ Transfusion Medicine Research Program Support Award.  

Earlier publications involving these and other researchers have also investigated the impact that blood donor age and sex have on outcomes for transfusion recipients, summarized evidence related to sex-matched versus mismatched transfusions and mortality, and the biological mechanisms implicated in adverse outcomes of sex-mismatched transfusions. There is still room for more investigation to build on this previously completed research, and that aligns with Canadian Blood Services' emphasis on the importance of research that spans the continuum from bench-to-bedside to continuously improve our processes, products and services. As Dr. Zeller describes: “There are biological studies and retrospective data, but we only have one existing RCT. There’s a real importance to pursue a prospective, RCT so we can look forward as opposed to looking back.”

“As every blood donor is unique, the challenge we have is to understand which donor-specific factors can be better matched to improve patient outcomes.  Differences in the biology of blood cells from male and female blood donors are well defined, but what we do not understand is if these differences affect health outcomes in transfused patients.  This is very important question that the SexMatters clinical trial is proposing to address.”

Dr. Jason Acker, Co-Investigator in the SexMatters trial

How will the study work and why the focus on transfusions in the ICU?  

Focusing on transfusions in the ICU is a significant distinguishing feature of this study. The iTADS trial was completed as a multicentre, double-blind trial, but it looked at mortality rates across the whole hospital. This new trial will look at transfusions received by patients in the intensive care unit (ICU) specifically. 

“In the hospital, we know that mortality rate is much higher in a transfused ICU patient compared to a patient in another part of the hospital,” Dr. Zeller says. “We’ve chosen to focus this study on the sickest population of patients – those in the ICU – with the idea that any impact will be seen most prominently in this group. The analysis will include consideration to dosage so we can adjust for the specific number of units transfused to each patient.” 

The study is also designed so that participants will not know whether a blood transfusion is matched or mismatched based on the sex of donor or recipient – a method used to prevent potential bias in the trial. 

“At the hospital, you always get a list with each shipment of blood product that says what units you have received from the blood operator”, Dr. Zeller explains. “As part of this study’s protocol, participating hospitals will see an additional colour-coding noted on this inventory, and this is what will be used when it comes time for us to do our analysis.”  

Who could benefit from this knowledge and what are the next steps?  

Dr. Zeller is glad to have Canadian Blood Services involved in this research, acknowledging that changing policy related to matching of blood products would be a significant change for hospitals and blood suppliers, requiring strong evidence from RCTs like this one.  

“This study will help to inform health-care professionals who prescribe and administer blood products, along with patients, donors, and the blood operator, too. One of the important questions if it does turn out to have a significant difference is ‘Then what?’ We already divide our inventory by group (ABO) and by Rh status (+/-). Would the need to be matching by sex further impact inventory? We don’t know yet, but that’s why it’s important to have the blood supplier involved,” Dr. Zeller says. 

The study will require a total sample size of approximately 11,000 patients across an expected nine hospital sites in Ontario.  

“We’ve designed this study to be very efficient; it’s got components of what would be considered a pragmatic study design,” Dr. Zeller says. “In terms of the products, Canadian Blood Services does not have to provide anything different than they already do for this study (other than the colour-coded markers) and we will use electronic capture to pull data, so we don’t need to collect study information at bedside. These were processes leveraged from the earlier iTADS study as the iTADS research team was very supportive of us learning from what they did.”  

“Whether transfusions should be matched for donor sex is a question that has been percolating in people’s minds for many years. Dr. Zeller has had the courage and perseverance to tackle this important question, which could have important policy implications.  I’m excited for Dr. Zeller to embark on this journey and advance knowledge on best transfusion practices.”  

Dr. Donald Arnold, Co-Director of CTTG and Co-Investigator in the SexMatters trial 

Canadian Blood Services – Driving world-class innovation 

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.