Ross FitzGerald

Ross works in Public Affairs and is a strategic communications specialist working closely with our Medical Affairs and Innovation Division. 

Funded research providing evidence needed to evolve eligibility criteria for men who have sex with men


Monday, December 03, 2018

Today, Canadian men are eligible to give blood if it has been more than one year since their last sexual contact with another man, which is known as the MSM eligibility criteria.

Canadian Blood Services has recently made progress on several fronts that may further evolve the eligibility criteria for men who have sex with men. This includes supporting more research projects as part of the MSM Research Grant Program and working to reduce the waiting period from one year to three months based on the latest evidence.

Supporting research

In October, four additional projects were funded as part of a second round of support available through the MSM Research Grant Program. This unique program, initiated in 2017, now combines research from a total of 15 research teams engaging researchers from across Canada with key partners and stakeholder organizations. Informed by national and international research experts, and actively managed by Canadian Blood Services and Héma-Québec, the program will generate evidence to inform alternative screening approaches for blood and plasma donors.

The newly funded projects investigate the feasibility of implementing source plasma donation with alternative screening approaches; the impact and opportunities for changes to blood donation screening; and mathematical modelling of the risk of transmission of viruses for various different strategies.

Summaries for all funded research projects are available on blood.ca 

The objective of the MSM Research Grant Program is to ensure the generation of adequate evidence-based research for alternative screening approaches for blood or plasma donors, which could evolve the current eligibility criteria for MSM while maintaining the safety of the blood supply. The program is administered by Canadian Blood Services and Héma-Québec with funding support from Health Canada.

Estimating risk 

Dr. Sheila O’Brien, associate director of epidemiology and surveillance with Canadian Blood Services, is the lead investigator of a couple of complementary projects that use mathematical modelling to better understand the risk of transfusion-transmitted infections. The projects, titled ‘Mathematical modelling – Comparing HIV risk between MSM donation strategies’, began in 2017 with support from the MSM Research Grant Program.

Dr. O’Brien is working to create and refine mathematical models that will more accurately estimate the risk of an HIV infectious unit of blood being released for transfusion if any changes are made to the eligibility criteria for donors. By comparing the risk associated with various possible changes to the eligibility criteria, informed decisions can be made as to which option may permit men who have sex with men to donate blood without compromising recipient safety and the sufficiency of the supply of blood products.

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Dr. Sheila O'Brien

Mathematical models allow us to estimate the chance of an infectious unit of blood being released to hospitals for transfusion. By changing the data we include in the model, we can compare various donor eligibility criteria and estimate the risk to the safety of the blood supply.” – Dr. Sheila O’Brien

Possible changes to the donor eligibility criteria that are being assessed include individualized risk assessment (in which the MSM question would not be asked) as well as shorter waiting periods.  The mathematical models are informed by data generated by research projects funded by the MSM Research Grant Program.

These interdisciplinary projects bring Canada’s blood operators, Canadian Blood Services and Héma-Québec, together with multiple national and international collaborators including experts from the Australian Red Cross, the American Red Cross, Public Health England, Santé Publique France, and the San Francisco-based Vitalant Research Institute.

Thanks in large part to the mathematical models already developed by this research, Canadian Blood Services and Héma-Québec can more accurately estimate the risks associated with reducing the waiting period for men who have sex with men. This refined risk assessment has been instrumental in setting the stage for a submission to our regulator, Health Canada, to reduce the waiting period for men who have sex with men from one year to three months.

Incremental change: submission to Health Canada 

While research efforts are underway, Canadian Blood Services continues to gather data on each blood unit collected, including pathogens tests results, and performs data analysis on a large scale. This surveillance approach has been instrumental in providing up-to-date information on the impact of reducing the waiting period for men who have sex with men to one year on the safety of the blood supply. We have discussed the results of the analysis with stakeholders (such as patient groups and LGBTQ+ groups) and with Héma-Québec, and are submitting a request to our regulator Health Canada to further reduce the waiting period for men who have sex with men to three months. 

This submission will be the latest incremental step by Canadian Blood Services to evolve the eligibility criteria for men who have sex with men. While the process is still in the early stages, we look forward to keeping the public updated on our progress.

As a blood operator, Canadian Blood Services has a responsibility to collect blood from donors who are at low-risk for any infection that could be transmitted through transfusion and who are unlikely to jeopardize their own health by blood donation. Difficult decisions need to be made about who can and cannot give blood. These decisions are not taken lightly and are not intended as value judgments of individuals. Any change to the eligibility criteria for men who have sex with men must be based on scientific evidence, acceptable to patient groups, and approved by our regulator, Health Canada.

More information about the eligibility criteria for men who have sex with men is available on 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.

MSM Research Grant Program launches second funding competition


Tuesday, January 30, 2018

Researchers are invited to apply for funding under MSM Research Grant Program

A new round of funding through the MSM Research Grant Program has just become available. Researchers can register their intent to apply by April 15, 2018 with proposals due by June 30, 2018.

The MSM Research Grant Program is funded by a contribution from Health Canada and managed by Canadian Blood Services in partnership with Héma-Québec. It was created to generate the evidence to inform alternative screening approaches for blood and plasma donors. The findings from research projects funded through the program could help to evolve the current eligibility criteria for men who have sex with men.

For the 2018 MSM Research Grant Program competition, the total funding available is $850,000. The Program will support small (up to $50,000) and large (up to $300,000) research projects that are aligned with the objective of the program and address one or more of the research priorities.  

The research priorities include: 

  • Research to evaluate the impact of alternative risk reduction technologies on donor screening. 
  • Research to evaluate operational feasibility of alternative donor deferral policies and their acceptability by Canadians. 
  • Risk modeling and surveillance to assess the risk associated with alternative donor selection policies. 
  • Research to inform the development of an individual risk assessment donor policy (behaviour based) or to strengthen the existing policy (population based). 

Background

In January 2017, Canadian Blood Services hosted an international meeting that brought together national and international stakeholders to identify research priorities for closing knowledge gaps that impact donor eligibility for men who have sex with men. The research questions and knowledge gaps identified at this meeting have been published in a review article by Dr. Goldman and colleagues titled Donor deferral policies for men who have sex with men: past, present and future.

Further reading: The evolution of a donor deferral policy: where do we go from here?

Last Spring saw the launch of the first competition. As a result, 11 research projects were funded and are now underway. 

Some of the topics and research areas include:

  • Surveys of MSM in urban, semi-urban and rural areas to determine how alternative screening approaches may impact their willingness to donate blood. 
  • An investigation into how to optimize the blood donor questionnaire to minimize any unintended negative biases. 
  • A study to determine suitable and unsuitable procedures for screening that maintain the safety of the blood supply. 
  • The development of mathematical models to estimate risk of an HIV infectious unit of blood being released for transfusion for different possible donor deferral policies.  
  • Surveys and studies to gather data about HIV-negative men who have sex with men to use in computer simulations to forecast any potential increase in risk to the blood supply.
  • A study of the Canadian population to identify safe subgroups of men who have sex with men.
  • A study to examine the acceptability and feasibility of a source plasma donation program for men who have sex with men. 

In December 2017, a meeting that brought together all the research leads associated with the first 11 funded MSM Research Grant Program projects was held. This was the first working meeting for the researchers to meet and discuss their projects and objectives. The meeting led to some new collaborations between the research teams especially as opportunities were identified to share donor questionnaires that have been developed for research purposes.

MSM Research Program team members are affiliated with a number of organizations across the country including Canadian Blood Services, Héma-Québec, McGill University, Ryerson University, Thorneloe University, Université de Sherbrooke, Université du Québec à Montréal, University of Toronto, University of Victoria, Western University, Community-Based Research Centre for Gay Men’s Health, Health Initiative for Men, Public Health Agency of Canada, and RÉZO.  

Over the coming months stay tuned to this space as we’ll be profiling the research projects, our partners and the research teams here on RED, our Research Education and Discovery blog.  

 


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 evolution of a donor deferral policy: where do we go from here?


Tuesday, January 30, 2018

New publication: Donor deferral policies for men who have sex with men: past, present and future

Dr. Mindy Goldman, medical director at Canadian Blood Services, along with coauthors Dr. Dana Devine and Dr. Sheila O’Brien also from Canadian Blood Services and Dr. Andrew Shih with the Vancouver General Hospital, recently published a review article in the scientific journal Vox Sanguinis, titled Donor deferral policies for men who have sex with men: past, present and future.

“Few donor criteria are as contentious as those for men who have sex with men…”, states the opening line of the paper – this is a truth and challenge that those of us working in the blood system and the affected potential donors who are deferred as a result face every day.

For interested readers, this paper (open access and free to read) is time well spent. It provides a comprehensive history of the evolution of this blood donor deferral policy around the world. It outlines the complexities of the current situation facing blood operators and their regulators, as well as the current research landscape. Most importantly it highlights the gaps in knowledge that have made consideration of further policy change challenging. It digs into what research questions need to be answered to possibly shorten the time-based deferral or to consider moving away from a time-based approach toward behaviour-based screening or other methods. 

As Dr. Goldman et al. describe in their paper, many of the knowledge gaps were identified by stakeholders at an international meeting held in 2017. This meeting was organized by Canadian Blood Services, in partnership with Héma-Québec, and with funding from Health Canada. Following this meeting, the MSM Research Grant Program was launched to fund projects that could address these gaps.

A first round of funding was distributed last summer. To date, 11 research projects are being funded with investigators from a number of Canadian institutions, as well as national and international partners.  A new round of funding under this program has just been opened so the timing of this publication is perfect as it will further inform the next round of research.

Read our next post  MSM Research Grant program launches second funding competition to find out more about the projects underway.

Further reading

 

 


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. Chantale Pambrun explains the importance of iron wellness


Wednesday, March 29, 2017

Iron is an essential element for producing hemoglobin (the molecule that helps transport oxygen around your body). To promote donor health, we recently made changes to donor eligibility based on new information our researchers have learned about mitigating iron deficiency in blood donors. 

On March 5, Canadian Blood Services increased the minimum allowable hemoglobin level for male donors from 125 g/L to 130 g/L. Back in December 2016, the interval between donations for female donors was increased from 56 days to 84 days. 

Read more on our Professional Education website: 
The importance of iron for whole blood donors: a Canadian perspective

Dr. Chantale Pambrun, medical consultant, donor and clinical services with Canadian Blood Services explains why we made these changes and provides some more information about why donor iron wellness is important.

 

As Dr. Pambrun explains, iron deficiency anemia is when you have low amount of hemoglobin. Red cells are packed with hemoglobin, and the role of hemoglobin is to take the oxygen from your lungs and circulate it throughout your body to provide oxygen to the vital cell activities. It also takes waste away from your cells and brings it back to your lungs to be expelled.

“When individuals have iron deficiency (or iron deficiency anemia), they may experience decreased exercise tolerance, increased shortness of breath with activity,” explains Dr. Pambrun, “possibly can also have a decrease in concentration or changes in mood.”

 

Learn more:

Ferritin findings: investigating iron and impacts on donors 

Tales from the engineering side of things

The importance of iron for whole blood donors: a Canadian perspective

 


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.

The opinions reflected in this post are those of the author(s) and do not necessarily reflect the opinions of Canadian Blood Services.

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