Tricia Abe

Fibrinogen replacement products: how do they stack up against each other?


Thursday, March 12, 2020 Tricia Abe

For patients who have cardiac surgery, the risk of severe blood loss is high if they have a condition called acquired hypofibrinogenemia — this means they have an undersupply of an essential blood clotting protein called fibrinogen. For these patients, doctors aim to minimize bleeding by giving them a fibrinogen replacement product to restore clotting factors to normal levels — either cryoprecipitate or fibrinogen concentrate — which restores clotting factors to normal levels.

Although both products are used in hospitals around the world, not much is known about how they compare in terms of limiting blood loss and adverse reaction rates; in North America, most hospitals use cryoprecipitate while most European hospitals use fibrinogen concentrate. The primary reason European countries made this transition over a decade ago was a concern about transmitting infectious diseases to patients with cryoprecipitate, which, unlike fibrinogen concentrate, is not treated to inactivate viruses and requires 10 donors to make a single dose.

A large-scale study conducted at 11 hospitals across the country with funding support from Canadian Blood Services to the QUEST research team at the University of Toronto, compared the effectiveness of cryoprecipitate and fibrinogen concentrate in controlling post-operative bleeding. The study’s key finding is that fibrinogen concentrate is equivalent to cryoprecipitate, the standard treatment in Canada.

Dr. Jeannie Callum
Dr. Jeannie Callum

Dr. Jeannie Callum, one of the study’s lead researchers, says the findings could have an impact on how cardiac patients are treated in Canada.

“This study shows that for hospitals where cryoprecipitate is the standard treatment for patients with acquired hypofibrinogenemia, it’s safe to switch to fibrinogen concentrate to control post-operative bleeding,” explains Dr. Callum. 

“Given the other benefits of fibrinogen concentrate — it’s a purified product, pathogen-reduced, and easier to administer — this is one more step we can take to ensure the safety of patients.”

To learn more about the study, read our Research Unit.

To see a recorded webcast of Dr. Keyvan Karkouti and Dr. Kathryn Webert discussing the impact of the study, visit https://transfusionontario.org/en/webcasts/ and select the UofT Transfusion Medicine Rounds presentation for Jan. 23, 2020.


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.

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Protecting patient safety: how tracking adverse events can help


Thursday, January 23, 2020 Tricia Abe

Although it doesn’t happen often, sometimes patients will have a bad reaction during or after a blood transfusion. These incidents can range from a minor complication like a fever or allergic reaction, to a life-threatening situation, such as when a patient’s immune system destroys the red blood cells they received through transfusion. When an adverse transfusion reaction happens, it gets reported to the hospital’s transfusion service, also known as the blood bank, and may be reported to the manufacturer and to provincial and national surveillance systems as well.

It’s one more reason why Canada’s blood supply is recognized as one of the safest in the world. 

Why all the tracking? Keeping track of adverse transfusion reactions — not only how often they occur, but also the specifics related to each event, including a description of symptoms, actions taken to manage the patient, the type of blood component or plasma protein product suspected of causing the reaction, and the patient’s outcome — is central to patient safety. For example, reporting could lead to other blood components from the same donor being recalled. Or, tracking could help identify points in the transfusion chain where errors occur so that improvements can be made.

For health professionals working in hospitals, the reporting pathways (which vary depending on what was transfused and the nature of the reaction) might seem confusing. In a recently published guide to reporting adverse transfusion events, Dr. Matthew Yan, a transfusion medicine physician and Canadian Blood Services medical officer, says, “As a general rule, if there is ever any doubt on whether reporting is required, it is better to over-report than under-report.” 

Collectively, the surveillance programs established to monitor the safety of our blood supply can help identify any new or emerging issues that could affect patient safety. It’s one more reason why Canada’s blood supply is recognized as one of the safest in the world. 


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.

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Thursday, February 22, 2018
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Thursday, February 22, 2018
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Knowledge dissemination is a vital step needed for research to be translated into new applications and improved processes. Through our Centre for Innovation, Canadian Blood Services conducts and supports research related to transfusion medicine and hematopoietic stem cell transplantation. KnowledgeInfusion webinars disseminate our research findings to Canadian Blood Services staff, helping them learn about exciting new discoveries and understand how they can be applied to address the organization’s challenges. The presentations are also recorded and shared on our Professional Education website to reach a broader audience.

Does sex matter in red blood cell transfusions?


Monday, December 23, 2019 Tricia Abe

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, Canadian Blood Services medical officer and assistant professor in the department of medicine at McMaster University. 

The study, “Sex-mismatched red blood cell transfusions and mortality: A systematic review and meta-analysis,” was published in May this year in Vox Sanguinis, a peer-reviewed medical journal covering hematology — the study of the physiology of blood.   

Dr. Zeller’s team summarized the evidence from studies that compared outcomes in patients who received sex-matched or sex-mismatched red blood cell transfusions. Their analysis suggests that sex-mismatched red blood cell transfusions may be associated with a higher risk of death, but more investigation is needed.  

Dr. Zeller notes that the findings need to be interpreted with caution because the quality of the evidence from the studies they analysed was very low. “Although our study looked at the outcomes of over 85,000 patients, we found only observational studies — which have a higher risk of bias — available for our analysis,” she says. “But the findings suggest sex-mismatching in red blood cell transfusion is a potentially important issue that needs to be more rigorously examined.” 


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.

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Patients with non-ABO red blood cell antibodies: transfusion best practices for professionals


Tuesday, December 10, 2019 Tricia Abe

When a patient who needs a red blood cell transfusion has unexpected red blood cell antibodies (non-ABO) in their blood, health-care providers have to make decisions about what kind of red blood cell units can be safely transfused. Finding the right match for the patient is crucial because in some cases, transfusing incompatible donor units — those with antigens that could react with the patient’s antibodies — can result in serious complications, including acute or delayed hemolytic transfusion reactions. When pregnant mothers have these unexpected antibodies, they may require specialized prenatal care because their fetus or newborn may be at risk for a potentially life-threatening disease called hemolytic disease of the newborn.

To support hospital transfusion services and health-care providers in making clinical decisions that optimize patient care and use of blood products, Canadian Blood Services published new serological best practices on its professional education website. Dr. Gwen Clarke, associate medical director of clinical services at Canadian Blood Services and clinical professor in the University of Alberta’s department of laboratory medicine and pathology, collaborated with resident physicians from the University of Alberta Hematological Pathology residency training program to develop the best practices. Included are recommendations for selecting donor red blood cell units and other guidance to ensure transfusion patients receive red blood cell units that are the best match for them while avoiding requests for antigen-matched units or additional testing when these are not required.

For more resources for health-care providers, including leading practices and clinical guidelines, visit Canadian Blood Services' professional education website


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.

ShareTweetShare

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