Red blood cell (RBC) transfusion is a mainstay of treatment for individuals requiring surgery, with traumatic injury, undergoing chemotherapy and with anemia due to bone marrow failure or other medical conditions. Despite this, red cell transfusion has been associated with poorer outcome in many of these patient populations [Hebert, 1999, Villaneuva 2013]. As well, it is a costly treatment and the product is often in short supply due to demands in excess of donor availability. Utilization trends increase year over year on a provincial and national basis, and this is unlikely to change in light of our aging population.
For these reasons, there is interest at all levels of care to ensure that RBC transfusion is undertaken only when necessary; when no other reasonable treatment option is available. My current research focuses on assessing blood transfusion practices and adherence to current recommendations.
Microparticle content of platelet concentrates is predicted by donor microparticles and is altered by production methods and stress.
Maurer-Spurej E and Larsen R and Labrie A and Heaton A and Chipperfield K
Temporal trends in the treatment of severe traumatic hemorrhage.
Heidary B and Bell N and Ngai JT and Simons RK and Chipperfield K and Hameed SM
Erroneous automated optical platelet counts in 1-hour post-transfusion blood samples.
Maurer-Spurej E and Pittendreigh C and Yakimec J and De Badyn MH and Chipperfield K
Platelet quality measured with dynamic light scattering correlates with transfusion outcome in hematologic malignancies.
Maurer-Spurej E and Labrie A and Pittendreigh C and Chipperfield K and Smith C and Heddle N and Liu Y and Yi QL and Barnett M
Posttransplant diffuse large B-cell lymphoma of "lymphomatoid granulomatosis" type.
Saxena A and Dyker KM and Angel S and Moshynska O and Dharampaul S and Cockroft DW
I am currently supervising a project to audit RBC transfusions administered across various hospitals in Greater Vancouver. We will gauge whether the transfusion was appropriate or inappropriate based on most current guidelines. The cumulative results of the audit will provide information to hospital Transfusion Medicine (TM) leaders, ordering clinicians, hospital executive and the Ministry of Health (MoH), and form a baseline for future RBC Utilization Management (UM) endeavors. This information will have the potential to influence quality outcomes for patients.Grants
2010-2011. Canadian Blood Services Grant. (Co-PI with E. Maurer) Comparison of in vivo outcome following transfusion of dynamic light scattering screened versus unscreened platelets.
2011. VCH Quality and Patient Safety. Development of On-line tutorial - Appropriate TM Practice for MD’s.
2010-2014. Co DIVO RCT: A randomized controlled trial of high quality platelet concentrates as determined by ThromboLUX score versus standard of care platelets in patients with hematological malignancy.Honours & Awards
Award for Excellence in Clinical Service, UBC Dept of Pathology and Laboratory Medicine, 2011.
Faculty of Medicine Clinical Excellence in Teaching Award, UBC. May 2007.