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Research and development: from vein to vein

Friday 12th Jan 2018

The Australian Red Cross Blood Service manages a pool of close to half a million volunteer donors and processes around 1.3 million blood donations every year to provide blood products to hospitals throughout Australia. Maintaining an adequate supply of safe blood and blood products is our mission, and one that is supported by a strategically focused research effort.

In all, some 70 researchers located in three states contribute to the research effort. Their specialities are diverse, including psychology, economics, statistics and engineering, as well as the more expected fields of cell biology, haematology and genetics. Collaborations with research institutes and universities ensure that Blood Service research remains globally competitive, and is well-placed to have positive impacts on the blood and broader health care sectors.

From an organisational perspective, research and development (R&D) at the Blood Service finds ways to maintain a balance between the types of blood collected, meet the requirements of patients, improve product shelf life, and minimise wastage, processing and distribution costs.

The right donor at the right time

The Blood Service is in the unusual position of being a business whose key raw material is a gift, given freely by volunteers. Understanding what motivates these volunteers, how to keep them coming back, and ensuring the right balance of blood types in the donor panel is the aim of our Donor Research team. Australia is one of the few blood services in the world to have established a Donor Research program, and our team includes researchers with co-appointments to major universities, including UNSW (psychology), UTS (biostatistics) and University of Sydney (economics). Recent research by this team1 has shown that directly addressing a first time donor’s anxiety in the period leading up to their first appointment can increase the chance they will follow through with their donation.

Insights into donor health and wellbeing using big data

The ongoing health and wellbeing of our donors is a high priority. Australia has a large pool of long-term plasma donors, and linking data from Blood Service records with health information will allow us to see if there are any long term impacts (positive or negative) of plasma donation. Through collaboration with the Sax institute, the Blood Service is linking donor records with information from the 45-and-up study and other databases such as PBS, disease registers and Medicare. The linked data sets will provide a valuable resource to examine whether there might be any association between blood donation and cardiovascular risk, bone fractures and other health outcomes.

Cool outcomes from frozen blood

Blood for use in transfusions is separated into three components: red cells, platelets and plasma, each of which has its own optimum storage conditions and shelf life. The short shelf-lives of six weeks for red blood cells and only five days for platelets make it a challenge to supply blood products to rural and remote areas.

After almost five years of research, the Blood Service’s research and manufacturing departments have together developed and implemented a process for preparing deep-frozen blood components in Australia. This ground-breaking work extends the shelf life of blood components up to 10 years by adapting and developing blood freezing and thawing technologies (known as cryopreservation).

Our researchers have gained particular expertise in the cryopreservation of platelets2, which are the most difficult component of blood to freeze and thaw successfully. To extend our knowledge of the effects of frozen platelets in patients, the Blood Service is participating in one of the world’s first clinical trials of frozen platelets in civilians3. The study compares the use of frozen platelets with fresh, never-frozen platelets in patients undergoing cardiac surgery, and outcomes are expected to provide valuable data to support the possible use of frozen platelets in non-military hospitals in the future.

Monitoring and controlling emerging risks

Australia has one of the safest blood supplies in the world. However, concern around transfusion-transmitted infections exists, especially in relation to emerging diseases such as Zika virus. Blood Service researchers are keeping a watchful eye on emerging disease risks, to allow the development of appropriate management strategies to future proof our blood supply.

Our research projects combine the study of prevalence and spread of viruses in Australia with rigorous assessment of other ways to reduce the risks to the blood supply. A group of technologies known as pathogen inactivation use ultraviolet light to inactivate viruses and other pathogens in blood products by damaging their DNA. These technologies are effective against a wide range of pathogens, some of which are not detected by routine testing. Of particular interest in the Australian context is a recent study by our researchers showing that both Ross River virus and chikungunya virus are effectively inactivated in platelet components using this technology4.

Molecular understanding

At the sub-microscopic end of the spectrum, our research scientists study blood on the cellular and molecular level to understand the changes that occur during storage, how transfused blood interacts with a recipient’s immune system, and to improve the matching of donors and patients.

Researchers harness massively parallel sequencing to solve previously intractable issues of blood group incompatibilities by probing the genome for changes that affect the more than 36 known blood groups. This research helps us provide appropriate transfusion support for people with rare blood types and leads to a greater understanding of the diversity within the modern Australian population. During the last three years, Blood Service researchers have discovered and documented several new blood group variants 5, 6 which have been added to international databases.

Conclusion

Historically, the establishment of blood banking depended on pivotal research, initially for cross-matching between donors and recipients, and to allow the storage of blood without clotting. Today, through the collaboration of researchers across disciplinary boundaries, research and development continues to contribute to the wellbeing of donors and patients, from vein to vein.

For more information about R&D at the Blood Service, visit www.donateblood.com/research or contact researchoffice@redcrossblood.org.au

Acknowledgement: Australian Governments fund the Australian Red Cross Blood Service for the provision of blood, blood products and services to the community.

References

  1. Masser B, et al (2016)  Transfusion , DOI: 10.1111/trf.13496
  2. Johnson L et al (2014) Transfusion, 54(8), 1917-1926
  3. Reade M et al (2013) Anaesth Intensive Care, 41(6), 804-805
  4. Faddy H et al (2016) Transfusion. doi: 10.1111/trf.13519
  5. Lopez G et al (2015) Transfusion. doi: 10.1111/trf.13450
  6. McBean R et al (2014) Vox Sanguinis, 107(S1), 17
Authors: 
Alison_Gould

Alison Gould

Scientific Communications Specialist

At the Blood Service, Alison works with members of the Research and Development team to share their stories of science with their colleagues, collaborators and the public. Alison trained in chemistry and biochemistry, and gained a PhD in biochemistry from the University of New South Wales. She worked as a researcher in the biotechnology industry developing and manufacturing biopharmaceuticals. She loves working with scientists from all disciplines, and helping others understand the significance of their research.

MRACI CChem
Member of the Australia Science Communicators
Linked in profile: https://www.linkedin.com/in/alisongould1?trk=hp-identity-name
Any other links: https://www.researchgate.net/profile/Alison_Gould2

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