Docket: 1-5449 Initial: JN 15449 February 10/98 CMAJ /Page 381 Customer: CMAJ

Canadian plasma

Giesinger does admit that the inquiry, and the events HIV following a donation are now 1 in 1 million. surrounding it, have made her job more difficult. How- Chances of contracting other viral infections such as he- ever, she added that everyone has learned to live with it. patitis B range from 1 in 60 000 to 1 in 1 million. “It’s been around so long that it’s kind of like a thorn in “It’s safe, extremely safe,” said Ferris, who thinks physi- your foot — after a while, you cians must inform patients that forget it’s there. they have a “much better “Plasma donors,” she added, chance” of being involved in an “are a special kind of people.” automobile accident than of re- The need for larger collec- ceiving an infectious blood tions is being driven by rapidly product. “Last night there were increasing demand for plasma probably 5 fender-benders in and plasma products. By collect- Thunder Bay alone . . . [but] ing plasma directly instead of there was not a single problem extracting it from whole blood, with the blood supply in donors at the Thunder Bay cen- Canada.” tre are able to give twice as In Thunder Bay, plasma do- much and are able to donate nations are made by appoint- more times each year. ment. First-time donors face an The procedure, called A Thunder Bay donor: collecting plasma is a 45- initial 2.5 hour processing ses- , takes about 45 minute procedure sion during which a medical his- minutes. Donors are connected tory is taken and a complete to 1 of 20 machines at the centre — each is worth $50 000 checkup is done. On subsequent visits there is a briefer — that automatically draws and centrifuges the blood and screening to check for any changes in the donor’s lifestyle returns red blood cells to the donor. “Come take your red or health. blood cells for a spin — that’s one of our slogans,” jokes Ferris said the World Health Organization recognizes Scott Ferris, a donor recruiter. that creation of a voluntary-donor base is the safest way to He said the Thunder Bay centre is on target in terms collect blood. An alternative method — paying for dona- of donor numbers and plasma production. Still, because tions — is common in the US. “I saw the [American] sys- controversy surrounding tainted blood continues to swirl, tem at work recently and I was disgusted — I couldn’t be- the job of filling the clinic’s 20 beds is not easy. However, lieve some of the things I saw. Canadians understand that Ferris thinks the atmosphere has been improving. “People we must not go this route.” are coming back. From what I can tell there has been a Unfortunately, Canada has long held the distinction of 180-degree shift in terms of the public focus. People do being one of the few developed countries that must pur- not seem so concerned about the safety issue anymore — chase blood products abroad. The Red Cross currently they are more concerned about whether the blood supply collects about 200 000 litres of plasma annually, but will be there for them.” 400 000 are needed and demand is growing. According to a recent CMAJ supplement (Expert The shortfall is covered by products purchased in the Working Group. Guidelines for and plasma US, but the costs of dependence on a foreign source are transfusion for adults and children. Can Med Assoc J measured in more than dollar terms. “During the Gulf 1997;156:S1[11]) the odds of becoming infected with War there was a definite shortage of blood products in Canada, partly because the Americans who supply our needs were also experiencing a shortage,” Chesterman re- Blood fractionation produces called. “In times of shortages they cut back [on exports], and we suffer.” slew of products To address this issue, the Red Cross has plans to de- velop 5 to 7 new permanent collection centres, with The fractionation process turns blood into many Thunder Bay’s site being the first. The Canadian plants different products, including albumin, factor VIII, are modelled on the Bayer Corporation’s collection facili- immune globulin and immune human globu- ties in the US. American experience indicates that areas lin. The plasma products that are currently pur- with populations of about 100 000 people and no other chased outside Canada include factor IX, globulin used to treat specific infections and antithrombin III. permanent blood-donor clinics are the best locations for plasma plants. It appears that Thunder Bay fits this bill well. ß

CAN MED ASSOC J •FEB. 10, 1998; 158 (3) 381