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What do you spend most of your day thinking about? Making improvements to Canada’s blood system. Sometimes that means management work at Canadian Blood Services; other times it’s more immediate work here at my lab, NetCAD, near UBC.
NetCAD carries out research using blood donations from people who are otherwise banned from donating—gay men, IV drug users, etc. How rare is your research? We’re the only facility like this in the country. We’re working on another in Toronto that could handle a much larger load: 400,000 units a year compared to the few hundred units we can do here.
How did NetCAD come about? Problems would arise in manufacturing blood components from donations, but it’s hard to troubleshoot those when you’re manufacturing things for hospitals—you can’t just start tweaking knobs without violating standard operating procedures. So it became obvious that we needed a place that could serve as our developmental sandbox.
NetCAD didn’t open until 2003. Why’d it take so long? I think we’d not previously entertained the possibility of changes at the magnitude we now entertain them.
What kind of changes do you mean? By 2008 we’d switched the whole country over to the “buffy coat method,” which makes a big difference for recipients. In the old days, a single platelet transfusion had material from five donors in it. The buffy method of processing donated blood got that down to four. Over the course of many months of transfusions, that means a recipient is exposed to far fewer donors, making things markedly safer. Our American colleagues are quite jealous that we’ve managed this.
What’s next? Pathogen-reduction technology is a potential game changer. We shoot ultraviolet light through blood plasma and platelets infused with riboflavin. It’s the same principle as pasteurizing milk, in a way. And it’s highly probable that it will inactivate new pathogens that are cousins of the pathogens we already know about. That should help with the “unknowns” concern of recipient groups.
Concerns because of the fraught history of donations in Canada? Canada’s tainted blood scandal—from the late 1970s to the early 1990s—killed 1,200 hemophiliacs by letting HIV and Hep C through. That’s more than in any other developed country. As a result, the Hemophiliac Society is a very effective political lobby group.
Research has changed policies around donation—Australia and the U.K., for instance, now let gay men who have not had sex for a year donate. How is Canada’s policy shifting? Our recent submission to Health Canada seeks to change things from a permanent ban to a time-based deferral—between five and 10 years. You need to manage patient fear. And that fear is based on a history. The Hemophiliac Society is telling us they recognize it’s time for a change, but they don’t want anything that they perceive will make transfusions less safe. It’s a significant first step. There’s the thing a blood recipient will trust, and there’s the thing the science bears out. And then there’s the gap between.