Sheila F. O'Brien

Current incidence and estimated residual risk of transfusion-transmitted infections in donations made to Canadian Blood Services

BACKGROUND: New testing methods such as nucleic acid amplification testing (NAT) and chemiluminescent serologic assays have been introduced, more precise estimates for infectious window periods are available, and a new method for estimating the residual risk (RR) of transfusion‐transmitted infections (TTIs) has been developed. Thus, available RR estimates for Canada need to be updated.

Hepatitis B virus DNA–positive, hepatitis B surface antigen–negative blood donations intercepted by anti‐hepatitis B core antigen testing: the Canadian Blood Services experience

BACKGROUND: The benefit of introducing anti‐hepatitis B core antigen (HBc) screening for intercepting potentially infectious donations missed by hepatitis B surface antigen (HBsAg) screening in Canada was studied.

Declining hepatitis C rates in first‐time blood donors: insight from surveillance and case‐control risk factor studies

BACKGROUND: Hepatitis C virus (HCV) rates have decreased steadily in first‐time donors in Canada since testing was implemented but reasons are unclear. A description of factors that may have played a role in this decline is reported.

Donor understanding and attitudes about current and potential deferral criteria for high-risk sexual behavior

BACKGROUND: Few donor criteria are as contentious as the deferral of men who have had sex with men (MSM). We performed an anonymous donor survey to determine attitudes toward current screening and the feasibility and acceptability of adoption of alternate donor criteria for MSM.

Iron deficiency in Canadian blood donors

The adequacy of communication and knowledge of donors and physicians regarding iron needs and the relationship between hemoglobin (Hb) and iron stores require evaluation to address donor iron deficiency.

Red blood cell processing methods and in-hospital mortality: a transfusion registry cohort study

BACKGROUND Quality of red blood cells (RBCs) varies depending on the method of processing the whole blood donation, and the method of processing might affect outcomes in patients transfused RBCs. We aimed to establish whether an association exists between in-hospital mortality and RBC processing method and duration of storage. METHODS We did a retrospective registry cohort study using data from three acute care hospitals in Hamilton, ON, Canada, and Canadian Blood Services over a 6-year period (2008-14). Adult patients (≥18 years) who were admitted to hospital and who received RBC transfusions were included in the study. All transfused RBCs were characterised by the method of processing (red cell filtered or whole blood filtered) and storage age (fresh 1-7 days, mid 8-35 days, and old 36-42 days). The primary outcome was in-hospital mortality. We used Cox proportional hazards regression with time-dependent stratification variables and fixed stratification variables, and controlled for patient covariates. FINDINGS Between April 1, 2008, and March 31, 2014, 91 065 RBC transfusions were given to 23 634 adults who were included in the analyses. When storage duration was included in the model, in-hospital mortality was significantly increased with fresh whole blood filtered units compared with the reference group of mid-age red cell filtered units (hazard ratio 2·19, 95% CI 1·09-4·42; p=0·033). Differences between other age and processing categories were not significant. INTERPRETATION The potential effect of whole blood processing methods on patient outcomes is worthy of further investigation, since adverse outcomes could be reduced by minor changes to blood processing methods and inventory management policies. FUNDING Canadian Blood Services, Health Canada, and the Canadian Institutes of Health Research.

Epidemiology of hepatitis B in Canadian blood donors

BACKGROUND: The residual risk of hepatitis B is higher than for other markers such as human immunodeficiency virus and hepatitis C virus in nonendemic countries. Evaluating the potential for further risk reduction requires a better understanding of the relationship between donor selection criteria, immigration from endemic countries, and public health vaccination strategies.

Predictive ability of sequential surveys in determining donor loss from increasingly stringent variant Creutzfeldt-Jakob disease deferral policies

BACKGROUND:  Predonation screening questions about travel increase the safety of the blood supply from diseases such as variant Creutzfeldt‐Jakob disease (vCJD) and malaria. This study examines the ability of sequential surveys to predict actual travel deferrals and the operational validity of travel questions.

Face-to-face interviewing in predonation screening: lack of effect on detected human immunodeficiency virus and hepatitis C virus infections

BACKGROUND: Predonation screening has become more elaborate over the years, while human immunodeficiency virus (HIV)‐ and hepatitis C virus (HCV)‐positive donations have declined. The impact of face‐to‐face interviewing and of the format of the Donor Health Assessment Questionnaire (DHAQ) have not been evaluated.

Reassessment of deferrals for tattooing and piercing

BACKGROUND: In August 2005, the Canadian Blood Services decreased the deferral period for tattooing and ear or body piercing from 12 to 6 months. This study assessed the impact of this change on blood safety and availability.