Transfusion Transmitted Injuries Section
Current Activities

Pilot Transfusion Transmitted Injuries Surveillance System

As a measure of blood safety, the Transfusion Transmitted Injuries (TTI) Section of the Health Care Acquired Infections Division (HCAID), in collaboration with Nova Scotia, Prince Edward Island, Québec and British Columbia, is developing a pilot Transfusion Transmitted Injuries Surveillance System (ttiss) to monitor the risk associated with blood transfusion. A core working group with representatives from Health Canada and from each pilot province was formed to work around the issues involved in developing and implementing the pilot ttiss. A final report on the activities of the pilot ttiss and recommendations on a structure for the national ttiss for reporting transfusion-related adverse events will be submitted to Health Canada.

This system will capture data on acute moderate and severe adverse events related to blood transfusion. These data will be analyzed at the national level, and the results will be disseminated to interested parties. The information may be used to support government policy development and risk management programs.

The ultimate goal of this program is, in collaboration with all provincial/territorial partners, to extend the pilot ttiss to a national system.

Transfusion Error Reporting System

Health Canada has funded the Sunnybrook and Women's College Health Sciences Centre in Toronto over a 2-year period (2000/2001 and 2001/2002) to assist with the implementation of the Medical Event Reporting System for Transfusion Medicine (MERS-TM). This is a no-fault transfusion error tracking system that was designed through a grant from the National Heart, Lung, and Blood Institute in the United States. The Sunnybrook and Women's College Health Sciences Centre is the only Canadian site that has participated in the implementation of this error tracking system. The purpose of the project is to examine the effectiveness of MERS-TM as a possible national standard for detecting errors and near-miss events of transfusion (i.e. the errors that were detected and prevented before transfusion). Investigation of these events and determination of their root causes would allow for appropriate corrective actions to enhance the safety of blood transfusion.

Pilot Blood and Marrow Transplantation Registry

As part of the Blood Safety Program, Health Canada has funded Ottawa Hospital Blood and Marrow Transplant Program to develop a pilot blood and marrow transplantation registry at the Ottawa Hospital-General Campus, with the aim of exploring the technical and financial feasibility for development of a national registry. Such a registry would allow for monitoring of adverse events and clinical outcomes of blood and marrow transplantation, including transmission of infectious diseases. Further, Health Canada has supported development of a formal business plan as a foundation for securing the required long-term sustainable funding for a National Blood and Marrow Transplantation Registry and clinical trial.

Blood-Borne Pathogens Surveillance System in Hemophilia Patients

Health Canada has funded the Association of Hemophilia Clinic Directors of Canada to (1) support the expansion of the Canadian Hemophilia Registry (CHR), so that clinical data from an existing national database, known as the Canadian Hemophilia Assessment and Resource Management information System (CHARMS), can be integrated with the CHR, and (2) establish blood-borne pathogens surveillance for patients with bleeding disorders through a comprehensive and serial collection of patients' serum and DNA samples for testing of known and emerging blood-borne diseases.

Study of Incidence of Viral Transmission in Apheresis Patients

Health Canada has provided funds for the Canadian Apheresis Group, during 1999-2003, to conduct a study to assess the potential risk of viral transmission in patients who undergo plasma exchange or therapeutic apheresis. Plasma exchange is the process of removing a large volume of plasma from the body and replacing it with appropriate fluids. This process is used to treat diseases in which abnormal substances or cells are present in the blood. Currently, the risk of transmission of known infectious agents to the recipients of blood/blood products is very low; however, the risk may be higher in apheresis patients because they usually receive a large volume of fresh frozen plasma or cryosupernatant, either alone or in combination with various cristalloids and intravenous IgG. For this reason, Health Canada is supporting a multi-centre study in order to determine the risk of transmission of viral infections in apheresis patients.

[Blood Safety Surveillance and Health Care Acquired Infections Division]