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RESEARCH AND DEVELOPMENTANNUAL REPORT 2015-2016

OUR

RESEARCHERS

DO TREMENDOUS

AND VALUABLE

WORK

Message from the chair and chief executive

Foreword

The year in review

TranslationProject outcomesQuality of research outcomesPublicationsR&D Highlights

Research program 2015-2016

Researchers Meet our research leadersDonor behaviourDonor health and wellbeingProduct development and storageProduct safetyProduct usage

Appendix 1: publications and invited presentations

Peer reviewed journal articlesPeer reviewed published abstractsInvited external presentationsInternal presentationsBooks and other materialsInternational database listings

Appendix 2: grants

Grants Active 2015-16New Grant Applications: Successful

Appendix 3: abstracts accepted for conference oral or poster presentations

Appendix 4: student projects

Appendix 5: collaborations

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CONTENTS

RESEARCH AND DEVELOPMENT ANNUAL REPORT 2015–2016

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MESSAGE FROM THE CHAIR AND CHIEF EXECUTIVE

Having both joined the organisation in early 2016, we are continually impressed by its collaborative, continuous improvement culture where our people hold the patient, donor and donor family at the heart of our thinking.

The Blood Service works as one team striving to be at the leading edge of improving the lives of patients, and critical to this is our Research and Development Team.

Our researchers do tremendous and valuable work. They collaborate with colleagues across the Blood Service, Australia and the world, and their results are recognised in a record number

of publications. Importantly, they combine scientific rigour and practical needs so we deliver on real world outcomes.

Our ability to translate and implement research results into robust practical solutions is both exciting and essential to bringing us closer to operating at the leading edge of national and international blood operations. This includes impressive advancements in areas such as providing frozen blood to the Australian Defence Force, improving the matching of donors and patients, and securing our blood supply with better ways to recruit and retain donors.

Research and Development at the Blood Service is well positioned to keep improving the lives of patients. This team’s experience and operational nous shine through in the many collaborations it fosters with industry, clinicians, academic researchers and health and blood sector organisations.

We are so proud of this team’s achievements over the past year which you can discover in this report. We look forward to the continued building of capabilities, expertise and knowledge, that will allow the Blood Service to provide even more value to the research community in the future, both through our individual work and partnerships as we strive to keep finding better ways to save and improve the lives of people.

Shelly ParkChief Executive

James Birch AMChair

It is our pleasure to introduce the 2015-2016 Annual

Report from the Australian Red Cross Blood Service

Research and Development Team.

Our Governance

R&D at the Australian Red Cross Blood Service undergoes regular reviews of scientific content, strategic direction and governance.

An R&D Framework has been developed in consultation with governments to guide our research direction. The framework outlines the scope of research activities at the Blood Service, defines the governance of the program and guides consultation and collaboration between the Blood Service and its stakeholders. As part of this framework, all R&D project proposals are submitted for independent peer review to a Research Advisory Committee consisting of local and international experts in the blood sector.

Outcomes from research projects are reported annually to the National Blood Authority, and published in peer reviewed journals.

HOW R&D SUPPORTS THE BLOOD SERVICETARGET: Translate more than 75% of research outcomes into changed practice or learnings.

Donor behaviour

Investigate ways to recruit, motivate and retain donors.

Donor health and wellbeing

Examine how to improve the donation experience and keep our donors happy and healthy.

Product development and storage

Explore ways to process blood more efficiently, improve storage life and reduce waste.

Product safety

Identify emerging risks and develop ways to measure and control them.

Transplantation and immunogenetics

We optimise the match between organ donors and patients.

Product usage

Analyse how donor variation, product processing and storage can improve patient outcomes.


FOREWORD

Research and Development at the Blood Service

has had another record year, building on last year’s

strengths, and moving forward into new collaborative

ventures. Our research outcomes have contributed

to all aspects of the business and ensured that

decision makers have access to a strong evidence

base for policy making in areas from donor

recruitment and selection to transfusion practice.

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Innovation, to be located at the University of Queensland (funded by the Australian Research Council) and the National Health and Medical Research Council (NHMRC) Centre of Research Excellence, known as APPRISE (Australian Partnership for Preparedness Research on Infectious Disease Emergencies).

To ensure our R&D program continues to grow into the future and to enable benchmarking with our international colleagues, this year we have reviewed our Key Performance Indicators, and are undertaking a review of our overarching strategy for the next five years. Input has been received from Executive, Board, Advisory Committee and others. Taking this feedback into account, along with a report we have received from an independent external consultant, we are now working with a small advisory group of prominent researchers to prepare our proposed update to the R&D Strategy.

This Annual Report highlights the key achievements of 2015-2016, which form a firm foundation for an exciting future of innovation.

David O. Irving Director, R&D

R&D business outcomes are on track with 100 percent of research projects completed in 2015/16 being translated into changed business practices or learnings. This year our research has inspired a new strategy to help first time donors manage their anxiety, explored methods to extend the shelf life of blood products, informed the risk management of Ross River virus and tracked the fate of thousands of O negative blood units in the health system.

Blood Service researchers have published 64 research papers in peer reviewed journals this year, continuing the significant growth in research output over the last five years, and breaking the record we set last year. In line with our strategic plan, there is a continuing growth in the number of publications written in collaboration with local and international collaborators. Our researchers continue to be recognised by their peers through selection for presentation at local and international conferences, with Blood Service researchers presenting a total of 53 conference presentations, 24 of which were international. In addition to these conference presentations, a further five invited presentations were made overseas to specialist groups, working parties and blood operators.

Collaboration and innovation are key to developing new diagnostics and treatments. We are proud to be part two new major collaborative Centres: the Centre for Biopharmaceutical

THE YEAR IN REVIEW

TRANSLATION

5

Translation of research outcomes into improved practice within the Blood Service and the health sector more broadly is a major focus for our research team. This year research projects have been translated into results across the organisation, to target donor recruitment, innovate in manufacturing, and ultimately improve outcomes for patients. As part of our R&D’s contribution to the Blood Service Strategic Plan, we aim to translate 75 percent or more of research projects into improved business practice or learnings. Our projects not only contribute to local changes in business practice, but inform clinical guidelines, quantify risk and build knowledge as a foundation for future development. In the 2015-16 year we completed 13 projects, all of which were translated into changed business practice or learnings that are applicable either internally or more broadly in the blood sector. These project outcomes are listed on the following page in Table 1.

Not all translations of research into outcomes will be apparent immediately at the conclusion of a project. One example of this is a donor anxiety research project which was completed in 2013. In 2015-2016, in collaboration with the Blood Service marketing team, this work has led to the introduction of a new business practice to assist new donors (described on page 23).

Translation of our results into the broader health sector is important if we are to improve outcomes for patients, and influence global

practice. We are increasing our global impact through stronger engagement with collaborators in Australia and overseas, and by broadening the dissemination of our research results in the research community and to the general public. We can track our impact in these spheres by a number of measures, including publication counts and citation indices. While the measures described here provide some indication of the translations of our research outcomes, no single measure will ever capture the full impact of our research projects. The metrics on the following pages, along with descriptive research highlights, provide a portrait of a research and development group whose impact is clearly on the rise.OUR PROJECTS BUILD

KNOWLEDGE AS A FOUNDATION

FOR FUTURE DEVELOPMENT


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PROJECT OUTCOMES

The projects completed in 2015-2016 have led to outcomes that have helped the Blood Service and the Blood Sector across a range of areas. The key outcomes from our projects this year are summarised below.

Completed project outcomes for 2015-2016 Translation category Key Outcome

Business practice

confirmed, change

recommended or potential

alternative suggested

• A study of markers of Hepatitis E (HEV) infection has been carried out. The vast majority of

overseas-acquired HEV infections in Australia were in travellers retruning from countries already

subject to travel-related donation restictions for malaria. This suggests that the potential for

transfusion transmitted HEV from overseas-acquired HEV in Australia is adequately managed

by existing Blood Service travel related deferrals.

• The transfusion-transmission of Ross River virus (RRV) in Australia is adequately managed

through existing donation restrictions and recall policies.

• The maternal blood test to assess the fetal RhD blood group was transferred to the Red Cell

Reference Laboratory in the Manufacturing Division in January 2016. This test will assist

in the management of pregnancies at risk of haemolytic disease of the newborn.

• A study of staff and donor attitudes to the use of techniques to avoid donor vasovagal reactions

has been used to inform an intervention trial targetted to reduce vasovagal events in 2016-2017.

• The READ approach to delivering education on the use of post-donation iron supplementation

was operationally feasible and well received by staff and donors.

• The DIRECT approach to providing iron for post-donation iron supplementation was operationally

feasible and well received by staff and donors.

• The suitability of an automated red cell washer (the ACP 215) has been confirmed, and conditions

for its use have been defined.

• Materials designed to inform the African-Australian community about blood donation have been

produced in consultation with the community. The Blood Service now has a series of posters,

booklets and videos that are available in English, Arabic, Swahili and Kirundi. The research

suggested that although the materials were well received, the targeted program did not directly

increase new donors from within the African community.

Learning applicable

internally only

• The stability of serum eyedrops was tested in the existing packaging system, and an alternative vial

system. The stability of the drops in both cases was suitable for further studies. As part of this study,

growth factor concentrations were measured in serum from a range of healthy donors.

Learning applicable to

the broader blood sector

as well as internally

• Genetic markers can be associated with high and low ferritin levels.The findings of this study provide

support that genetic testing may, in future, allow the Blood Service to tailor management strategies to

individual donors, based on their genes.

• All three biomarkers of dengue infection (antibodies, RNA and surface protein) can be detected

using a test developed in collaboration with the Australian Institute of Bioengineering and

Nanotechnology and the Institute for Molecular Bioscience.

• New proteins essential to red cell biology have been discovered. This has led to the development

of a new proposal to discover targets for new biopharmaceuticals directed at infectious diseases,

such as malaria, that target red blood cells.

• Cellular markers have been found that are associated with the outcomes of IVIg treatment in patients

with neurological disease. A larger patient cohort would be required to assess the specificity of this

test in predicting clinical outcomes for these patients.

THE YEAR IN REVIEW

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PARTNERS IN INNOVATION Blood Service researchers are partners in a successful $4.3 million bid for an Industrial Transformation Training Centre, funded by the Australian Research Council. This centre is one of only six industrial transformation centres announced nationally across a range of industries, and is one of only two in the health sector. The centre, known as the Centre for Biopharmaceutical Innovation (CBI), aims to transform Australia’s growing biopharmaceutical industry by training industry –ready postgraduates and post-doctoral fellows.

Research at the CBI will focus on developing and manufacturing new biologically based therapies and training a cohort of specialist scientists in industry relevant research.

The Centre will be based at the University of Queensland, integrating industry partners CSL (Australia’s largest biotechnology company), Patheon Biologics (a major international Contract Manufacturing Organisation (CMO), and Australia’s first large CMO of biopharmaceuticals), GE Healthcare (a supplier of high tech equipment and instrumentation), and the Blood Service.

This collaborative centre gives Blood Service R&D the opportunity to explore research at the interface of the blood sector and industry, such as new reagents for blood typing, diagnostics and therapies. It contributes to our strategic objective of increasing collaboration, and raises the profile of Blood Service R&D in the Australian Life Sciences community. The CBI will support 14 PhD students and five post -doctoral fellows in three themed areas of discovery, development and manufacturing, driving growth in the sector by emphasising the translation of research into outcomes relevant to the industry partners. Of these, three PhD students and one post-doctoral fellow will be working on Blood Service research.


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Publication quality metrics

One measure of a researcher’s impact on their field is the h-index. This index is an independently calculated metric that combines productivity with the citation impact of a body of published work. The average h-index for our investigators in 2015-16 was 11.36, an improvement over the previous year’s value 10.23.

The index is based on the set of the investigator’s most cited papers and the number of citations they have received in other works. For example, an h-index of 10 means the investigator has 10 publications with at least 10 citations each.

Presentations

Blood Service researchers gave a total of 53 conference presentations during 2015-2016, 24 of which were international. In addition to these conference presentations, a further five invited presentations were made overseas to specialist groups, working parties and blood operators.

At the upcoming meeting of the International Society for Blood Transfusion, to be held in Dubai in September 2016, our researchers have been selected to give nine oral presentations covering all aspects of our work from donor psychology to detailed immunology.

Receipt of external funding grants

This year we have been successful, along with external partners, in new grant applications totalling $10.5 million (over the lifetime of the grants). A large proportion of the funding has been awarded to two significant partnerships, each of which has built on past, smaller collaborations with one or more of the partners.

The first is an Industrial Transformation Training Centre, funded by the Australian Research Council (ARC). This centre is one of only six industrial transformation centres

announced nationally across a range of industries, and is one of only two in the health sector. The centre, known as the Centre for Biopharmaceutical Innovation (CBI), aims to transform Australia’s growing biopharmaceutical industry by training industry-ready postgraduates and post-doctoral fellows.

Research at the CBI will focus on developing and manufacturing new biologically based therapies and training a cohort of specialist scientists in industry relevant research.

The Centre will be based at the University of Queensland, integrating industry partners CSL, (Australia’s largest biotechnology company), Patheon Biologics (a major international ContractManufacturing Organisation, and Australia’s firstlarge contract manufacturer of biopharmaceuticals), GE Healthcare (a supplier of high tech equipment and instrumentation), and the Blood Service. The Centre has received funding of $4.3 million from the ARC over five years.

QUALITY OF RESEARCH OUTCOMES

THE YEAR IN REVIEW

The Blood Service will also be part of a new National Health and Medical Research Council (NHMRC) Centre of Research Excellence, known as APPRISE (Australian Partnership for Preparedness Research on Infectious Disease Emergencies). The partnership brings together experts in “four pillars” of clinical research, public health, laboratory research and culturally and linguistically diverse communities to co-ordinate a strategic, collaborative national approach to infectious disease preparedness. These areas are supported by cross-disciplinary involvement of specialists in ethics, data management, education and training, and leadership and integration.

There are ten participating institutions in the partnership, including universities throughout Australia, the Kirby Institute, the Menzies School of Health Research and the Blood Service. APPRISE has a total budget over five years of over $4.9 million.

Awards

Throughout the year, R&D staff were recognised through a variety of awards, which are listed on page 13 (Table 2).

In addition to these awards to Blood Service researchers, material arising from one of our collaborations won a Multicultural Health Communications award. The award was presented by the NSW Health Minister Jillian Skinner to the Centre for Health and Social Responsibility for the work “Blood from everyone for everyone: Information for the African community about blood donation in Australia”, which was funded by the ARC and included researchers from the Australian Catholic University, Deakin University, Western Sydney University and the Australian Red Cross Blood Service.

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During 2015-16, R&D researchers authored or co-authored 64 peer-reviewed publications based on their reserch at the Blood Service. For the third successive year, there has been a significant increase in the research output of Blood Service R&D, as measured by peer reviewed publications. Furthermore, the engagement of our research team members

with the research sector both in Australia and overseas has increased, evidenced by the rising number of research papers published in collaboration with external researchers. In 2015–16, 45 collaborative papers were published, 19 of which involved international collaborations, more than double the number of international collaborations in 2014–2015.

PUBLICATIONS

0

10

20

30

40

50

60

70

80

Increased publications and collaborations

Blood Service R&D authors only International collaborators Australian collaborators

2012/13 2013/14 2014/15 2015/16

THERE HAS BEEN A SIGNIFICANT

INCREASE IN THE RESEARCH

OUTPUT OF BLOOD SERVICE R&D

01

R&D HIGHLIGHTSIn 2015-2016, R&D actively engaged with all other divisions of the Blood Service to ensure our research results are translated effectively into business outcomes. Throughout the report, you will find key results from our research program highlighted as case studies.


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One of our researchers, Dr Lacey Johnson, was publically acknowledged for her work when she was awarded the Alumni Award for Excellence from the Faculty of Science at the University of Technology, Sydney (UTS) in 2015. This award was in recognition of her ongoing contribution to the field of platelet research and platelet cryopreservation. As Alumni Award winner, Dr Johnson was also invited to give the occasional address at the Autumn Graduation Ceremony for the UTS Faculty of Science.

Researchers in R&D are actively engaged in training the next generation of researchers for the blood sector, through the supervision of postgraduate students. A full listing of our students, their projects and supervisors can be found in Appendix 4.

During the year, Katrina Kildey completed the final milestones required for her PhD study, supervised by Dr Melinda Dean. Katrina was awarded her PhD from the Queensland University of Technology in March 2016 for her thesis entitled “Genetic studies of red blood cell differentiation and stability: ENU-induced murine mutations.” Ashish Shrestha (featured on page 18) also submitted his PhD thesis this year.

As we look to the future, we can expect further postgraduate completions in the years to come. This year four students completed the confirmation of their PhD candidature, the first hurdle on the journey to their doctorates. They are Marie Anne Balanant, Alexis Perros, Dr Liam Byrne, and Annette Sultana.

Three honours projects were completed, and all were awarded First Class Honours. The successful students were Anna Coghlan and Elise Hewlett supervised by Dr Helen Faddy, and Ben Wood supervised by Dr Lacey Johnson. Ben’s work has already been the basis for two manuscripts published in Transfusion.

Research is organised into areas that align with the value chain of the Blood Service, namely:

• Donor Behaviour• Donor Health and Wellbeing• Product Development and Storage• Product Safety• Product Usage• Transplantation and Immunogenetics

The impact of our research effort locally and internationally is continuing to grow. This year, we produced a record 64 peer reviewed publications and presented over 50 conference presentations, 6 of which were oral presentations at international conferences. Our researchers were accepted to give nine oral presentations at the conference of the International Society of Blood Transfusion in Dubai, to be held in September 2016. Dr Melinda Dean and Dr Kelly Winter each recieved Harold Gunson Fellowships to attend the conference.

Closer to home, three Blood Service researchers were selected for the ANZSBT Presidential symposium the HAA conference in 2015. This symposium is a forum to showcase the six best abstracts at the conference.

The strategically focussed research effort of the

Blood Service is powered by some 70 researchers

located in three states of Australia. Their specialties

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.

RESEARCHERS

RESEARCH PROGRAM 2015–2016

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Table 2: Awards presented to Blood Service researchers. This table shows a full list of awards made to R&D researchers.

Awards presented to Blood Service researchersAwardee Name of award Date awarded

Annette Sultana ANZSBT Travel award July 2015

Katrina Ki CSL Behring Overseas Travel Grant August 2015

Shereen Tan HAA Young Investigator Award October 2015

Lacey Johnson UTS Alumni Award for Excellence -Faculty of Science October 2015

Ben Wood Best Poster Presentation - New Horizons Conference November 2015

Emily Jenkins Dean’s Prize for best presentation by a Summer Student February 2016

Melinda Dean Harold Gunson Fellowship (ISBT) May 2016

Kelly Winter Harold Gunson Travel Award (ISBT) May 2016

THE IMPACT OF OUR RESEARCH EFFORT

LOCALLY AND INTERNATIONALLY IS

CONTINUING TO GROW


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Our Director

Prof David Irving Director Research and Development

With formal training in biochemistry, cell and molecular biology and management, Professor Irving has over 25 years’ experience in the biomedical and life sciences. His early research interests were focussed in the field of molecular approaches to parasite vaccine development, in particular malaria vaccine development. He held postdoctoral positions at the Rockefeller University, New York, and CSIRO, Sydney and has an MSc and PhD from the Australian National University and a Graduate Certificate of Management (Technology Management) from Deakin University. He is also a Graduate of the Australian Institute of Company Directors.

He was the inaugural CEO of the Diabetes Vaccine Development Centre (DVDC) and held executive management positions with Biotech Australia Pty Limited, Sydney and its successor companies.

Donor research

Dr Tanya Davison National Donor Research Manager

Dr Davison is a Clinical Psychologist, with a research and clinical background in mental health. She leads the Donor Research team, investigating ways to improve the recruitment and retention of blood donors, as well as maintain donors’ health and wellbeing.

Donor behaviour

Dr Anne van Dongen Honorary Research Fellow

Originally from the Netherlands, Dr van Dongen worked at the Dutch Blood Service Sanquin for 10 years. She obtained her PhD in Health Psychology, focussing on the retention of new blood donors. Currently, Anne’s research aims to map the emotional journey of new and novice donors, resulting in interventions to retain these donors.

Donor behaviour

A/Prof Barbara MasserVisiting Principal Research Fellow

Associate Professor Masser’s research focuses broadly on the psychology of blood donor recruitment and retention, with a current focus on emotion in donor decision-making and barriers to plasmapheresis.

Donor behaviour

Dr Alison Carver Research Fellow

Dr Carver’s current research focuses on the recruitment of male donors, first appointment plasmapheresis and retention of O negative donors. She was awarded her PhD in Behavioural Epidemiology at Deakin University.

MEET OUR RESEARCH LEADERS



Dr Denese Marks National R&D Leader - Product Development and Storage

Dr Marks’ research focuses on all aspects of improving blood component quality and safety from blood collection through to processing, storage and transfusion. This includes development of novel blood products such as platelet lysate and frozen blood components.


Dr Lacey Johnson Principal Research Fellow

Dr Johnson completed her PhD at The University of New South Wales, which focussed on understanding the mechanisms leading to the maturation of megakaryocytes, the parent cell of platelets. At the Blood Service her primary focus is improving the quality of platelets for transfusion.


Dr Barbara Bell Donor Vigilance & Clinical Research Manager

After graduating in medicine from the University of Sydney, Dr Bell completed training in clinical immunology. Her areas of interest include the use of quality systems in medicine to enhance clinical outcomes and the prevention and management of adverse events in blood donors.


Dr Dianne van der Wal Senior Research Fellow

Dr van der Wal is interested in platelet signalling. During her Ph.D. (Utrecht University, the Netherlands), she demonstrated that novel death pathways were triggered in cold-stored platelets as a result of molecular changes in one of the platelet adhesion receptors. Her current project focuses on the platelet responses of apheresis platelet donors.


Dr Stephen Wright Honorary Research Fellow (Biostatistics)

Dr Wright’s main research interest is the intersection between modern statistical methods and applied science. His analysis expertise includes applying generalised linear mixed models, competing risk regression, and data linkage methods.


Dr Celine LohResearch Fellow

Dr Loh received her Bachelor of Science from the University of Malaya, Malaysia and obtained her PhD from the University of Sydney. Dr Loh’s current research focuses on the development and characterisation of platelet lysate for in vitro propagation of human therapeutic cells, such as the mesenchymal stromal cells.


Product safety

Prof Robert FlowerNational R&D Leader – Product safety

Professor Flower’s research focuses broadly on transfusion safety, with teams using in vivo and in vitro models to investigate impacts of transfusion and the application of genotyping to improve the matching of blood for patients. Robert has a strong commitment to education and teaches TAFE, university undergraduate and medical advanced trainees.

Product safety

A/Prof Catherine Hyland Principal Research Fellow

Associate Professor Hyland was awarded a PhD from the University of Queensland for studies characterising the molecular diversity of the Rh blood group system. Her current research interests include circulating cell-free DNA and non-invasive prenatal assessment for the fetal RhD blood group and other atypical blood group antigens.


Dr Kelly WinterResearch Fellow

Since completing her PhD in 2009, Dr Winter’s research has focused on improving blood processing and component quality. Her recent research includes work in the Frozen Blood Programme comparing red cell additive solutions for the resuspension of deglycerolised red cells and optimisation of the deglycerolisation process to improve product quality.

Product safety

Dr Melinda DeanSenior Research Fellow

Dr Dean received her PhD from the University of QLD in 2009. Her current research is focused on investigation of red blood cell structural integrity, and the identification of biomarkers to predict adverse patient outcomes in transfusion.


Dr Joanne TanResearch Fellow

Dr Tan completed a PhD at the University of Sydney (Westmead Millennium Institute) in the area of molecular biology and infectious diseases. Her recent research projects focus on the characterisation and efficacy of serum eye drops, and the responder/non-responder profiles in anti-D donors following RhD-positive red blood cell immunisation.

Product safety

Dr Helen FaddySenior Research Fellow

Dr Faddy received her PhD from the University of Queensland in 2008. Helen’s research activities focus on providing an evidence base to enable the evaluation of current emerging infectious risks to the safety of the Australian blood supply.


Product safety

Dr Elizna Schoeman Research Fellow

Dr Schoeman received a PhD in Biochemistry from the North West University, South Africa in 2011 and was employed there in a postdoctoral research fellow position in 2012. Her current interests lie in developing new strategies for blood typing to improve transfusion safety.

Product usage

Elizabeth KnightClinical Research Project Manager

Elizabeth has a Science degree in physiology and pharmacology and a Masters in Public Health from the University of Wollongong. She has over 15 years working in the Clinical Trial environment, including 3 ½ years for the University of British Columbia in Vancouver, Canada. During her career she has worked in South Africa, Thailand, Vietnam, Singapore, Philippines and New Zealand.

Product safety

Dr John-Paul TungSenior Research Fellow

Dr Tung’s research is focused on better understanding the effects and possible negative outcomes associated with transfusion, especially of stored blood products. His particular focus is on transfusion-related acute lung injury or TRALI, with his doctoral thesis, conferred from the University of Queensland in 2012, describing the development of the first large animal model of TRALI.

Product usage

Dr Wayne DyerSenior Research Fellow

Dr Dyer received his PhD in viral immunology from the University of NSW in 1999, and has been a research scientist at the Blood Service since this time. Wayne’s current research activities focus on providing an evidence base for usage and dosing of fractionated plasma products, with current studies investigating IVIg and fibrinogen products.

Product safety

Dr Elvina Viennet Research Fellow

Dr Viennet completed a Doctor of Philosophy degree in Medical and Veterinary Entomology and Bio-Ecology from Cirad-CMAEE, Montpellier (Fr) in 2011. Elvina has a strong interest in infectious disease, especially in vector-borne diseases, and a particular interest in understanding virus transmission to optimize the prediction of new outbreaks.

Product usage

Dr Rena Hirani Research Fellow

Dr Hirani obtained her PhD in biochemistry and molecular biology from the University of Adelaide. She is currently involved in projects analysing the molecular changes that occur in patients who receive a blood transfusion, the use of genotyping techniques to match blood components more closely between patients and donors and the clinical usage patterns for high demand blood components.

INTERNATIONAL STUDENT PROGRAMThe Research and Development team welcomes students, including those from overseas, to take part in our research program. One of our research students, Ashish Shrestha, came to us from Nepal almost three years ago and handed in his PhD in June 2016 supported by a University of Queensland International Scholarship. Last year he was selected, along with seven others from around the world, to take place in an innovative program to train young investigators.

His PhD research involved studying the risk of hepatitis E virus to the Australian blood supply, and he has extended his work to a similar study in his home country of Nepal, where he was collecting samples a month after the earthquake that devastated that country last year. During his final year of research, he was selected to take part in the global training program known as I TRY IT, developed by the International Society of Blood Transfusion (ISBT) Transfusion-Transmitted Infectious Disease (TTID) Working Party. The aim of the eight-month program was to train young researchers to develop, review and report on research projects in transfusion transmitted infectious diseases. Ashish was enthusiastic about his experience. “We had an opportunity to learn from experts from the US, Germany and South Africa.”

“I believe I have chosen the right place to get involved in research. The Blood Service is an amazing place to explore ideas. With the availability of experts, and friendly and co-operative staff, it’s certainly an ideal place to learn and develop your ideas and skills.”

THE RESEARCH

EFFORT OF THE

BLOOD SERVICE IS

POWERED BY 70

RESEARCHERS


20

The Donor Research team has added significant expertise in the last twelve months. Recent additions to the team are Honorary Research Fellow, Dr Anne van Dongen and Research Fellow, Dr Evarn Ooi, both of whom are joint appointments with our university collaborators. Along with Dr Stephen Wright, who holds a joint appointment at the University of Technology, Sydney and A/Prof Barbara Masser at the University of Queensland, the team has forged strong and formal links with some of Australia’s leading universities.

Members of our Donor Research team presented at the annual conference of the Society of Australasian Social Psychologists held in Brisbane from 31 March-3 April 2016. This conference is the most popular venue for dissemination of psycho-social research within Australia, and attracts international, as well as local researchers. Oral presentations by Carley Gemelli and Amanda Thijsen generated many new contacts, and were of particular interest to the conference participants due to their applied approach.

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 the University of NSW, (psychology), the University of Technology, Sydney (biostatistics), the University of Queensland (psychology) and the University of Sydney (economics). The goal for this team is to deliver leading edge research that is cost-effective and translates into evidence -based business practice, while expanding academic knowledge about blood donation.

The Donor behaviour research theme focuses on recruitment, retention, conversion, flexibility and sustainability of plasma, platelet and whole blood donor panels.

Research in this theme examines:

• Demographic, psychological, social, organisational and environmental factors that predict, explain, and augment donation behaviour

• Tailored interventions to meet the needs of blood donors from different sections of the community

• Methods to inform communication and service interactions with blood donors

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 behaviour team.

DONOR BEHAVIOUR


21

OUR KEY RAW

MATERIAL IS A GIFT,

GIVEN FREELY BY

VOLUNTEERS. WE TRY

TO UNDERSTAND WHAT

MOTIVATES THESE

VOLUNTEERS, HOW TO

KEEP THEM COMING

BACK, AND ENSURE

THE RIGHT BALANCE

OF BLOOD TYPES IN

THE DONOR PANEL


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Table 3: Donor Behaviour projects. This table shows project titles and Blood Service investigators. Our external collaborators are shown in Appendix 5.

Donor behaviour Completed projects

DB 14-01 Evaluating a model for culturally relevant interventions to increase blood

donation and overcome perceived blood donation barriers among migrant communities

Dr Tanya Davison

Ongoing projects

DB 14-02 The role of pride in motivating and maintaining blood donations Amanda Thijsen, Carley Gemelli,

DB15-02 Recruitment of male donors Dr Alison Carver; Dr Tanya Davison;

A/Prof Barbara Masser; Kathleen Chell

DB15-03 Behavioural economics to better understand blood donations to inform

policy and practice (ARC)

Evarn Ooi, Dr Tanya Davison

DB15-04 Emotional psychology of blood donors (ARC) A/Prof Barbara Masser, Dr Anne van Dongen,

Amanda Thijsen, Dr Tanya Davison

DB16-02 Informing new donors about different donation types Dr Alison Carver, Dr Tanya Davison,

A/Prof Barbara Masser, Carley Gemelli,

Carmela Germano

DB16-04 Hospitals to Hospitality: Understanding the influence of Interaction

with staff and service quality on donor intention to donate

Dr Tanya Davison

Abandoned projects

DB 15-01 Developing donor willingness to change donation types as required:

an empirical investigation (this project was redesigned to continue as DB 16-02:

Informing new donors about different donation types)

A/Prof Barbara Masser (University

of Queensland, Australian Red

Cross Blood Service)

PROJECTS

01

DONOR RESEARCH: BEATING THE BUTTERFLIESWhen a first time donor makes an appointment to give blood, their initial good intentions can give way to “butterflies” as their donation approaches – and sometimes they don’t follow through with their donation as a result. A new strategy devised by our donor research team is designed to help donors manage their anxiety through this critical period of their donation career.

The novel approach is based on research led by Dr Barbara Masser (Honorary Principal Research Fellow at the Blood Service, and Associate Professor at the University of Queensland). Barbara explains “There is a voice at the back of new donors’ heads saying ‘You don’t have to do this. You could just not do it, that’s OK’. So we’re trying to intervene in that period and say ‘We know. We recognise that you are thinking all these things. It’s not that unusual, and here are some things you can do to manage those doubts”.

The R&D team worked with the marketing team to develop a range of materials to assist new donors. The materials were tested on over 3600 new donors. Using an internationally respected research design, the outcomes of this study told us that an emailed brochure in combination with a phone call produced the best result, and is the basis of a new business practice.


Research in this theme examines:

• Demographic, psychological, social, organisational and environmental factors that can predict, explain and improve donor health

• Evidence-based interventions to enhance the wellbeing of blood donors

• Applied research to inform communication and service interactions with blood donors

Projects underway in this theme are shown in Table 4 on page 26.

The overall aim of this work is to develop knowledge that can inform Medical Services policy and standard operating procedures.

This will help us to care for donors at the donor centre and throughout their donation career. 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 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 the Pharmaceutical Benefits Scheme, 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.

This year the Donor health and wellbeing team welcomed Dr Barbara Bell, who has previously been the National Medical Services Manager. She joins the R&D team as National Donor Vigilance and Clinical Research Manager and brings with her a broader medical input into our portfolio of research projects.

The ongoing health and wellbeing of our donors

is one of our highest priorities. The Donor health

and wellbeing research theme focuses on prevention

and management of donation-related adverse events

and the promotion of long-term donor health.

DONOR HEALTH AND WELLBEING

WE FIND WAYS TO IMPROVE THE

DONATION EXPERIENCE AND KEEP

OUR DONORS HAPPY AND HEALTHY

24


25

REDUCING DONOR ADVERSE EVENTSSome donors react to the sight of blood or a needle by feeling dizzy, becoming sweaty or feeling nauseous. This is known as a vasovagal reaction, and the symptoms are caused by a sudden drop in blood pressure and heart rate. Donors who experience them are at higher risk of sustaining an injury and often feel embarrassed or anxious.

Research has found two simple ways to reduce these symptoms. One is to drink 300ml of water ten minutes before the donation (known as water loading), and the other is a set of simple exercises during donation. If a person crosses their legs and tenses their inner thigh and abdominal muscles for five seconds while maintaining steady breathing (known as applied muscle tension), their blood pressure increases within two to three seconds.

Many donors are not aware of these two techniques. Our researchers tested different educational materials for whole blood donors to increase the use of water loading and applied muscle tension.

We selected 600 donors with a whole blood appointment at one of two donor centres and two days before their appointment, we sent each of them an email to help them prepare for their donation. The donors were randomised into one of four groups:

• Group 1 received a link in their preparation email to an online instruction video

• Group 2 received a link in their preparation email to a webpage with VVR prevention information

• Group 3 received an instruction card at the donor centre

• Group 4 was a “business as usual” group.

Donors who received the onsite instruction card reported greater use of water loading, awareness and use of applied muscle tension, and had a higher collected blood volume. We also had positive feedback from participants: “I enjoy giving blood, this was my 85th donation and I have not had any problems in that time. I have not heard of muscle tension exercises but if they help, very good”.

The findings of this study highlighted the important role that donor centre staff play in providing donor education on VVR prevention. In our follow-up study, we are working with donor centre staff to develop new training materials for staff to improve the routine use of VVR prevention techniques.

PROJECTS


26

Table 4: Donor Health and Wellbeing projects. This table shows project titles and Blood Service investigators. Our external collaborators are shown in Appendix 5.

Donor Health and WellbeingCompleted projects

DH 14-01 Prevention of and response to donor vasovagal events:

Staff and donor perspectives

Amanda Thijsen, Dr Stephen Wright

DH 14-02 The REplacement ADvice (READ) study Dr Anthony Keller, Dr Joanna Speedy,

Dr Tania Brama, Dr Sant-Rayn Pasricha,

Dr Hannah Salvin and Dr Denese Marks.

DH 14-03 Provision of iron replacement to donors (the Donor Iron REplaCemenT

Study- DIRECT study)

Dr Anthony Keller, Dr Joanna Speedy,

Dr Tania Brama, Dr Sant-Rayn Pasricha,

Dr Hannah Salvin and Dr Denese Marks.

DH 14-04 Genetic factors associated with donation career Ms Yu Ji, Dr Helen Faddy, A/Prof. Catherine

Hyland, Prof Robert Flower, Dr Daniel Waller,

Dr Melinda Dean

Ongoing projects

DH15-01 A trial of interventions to increase adherence to applied muscle tension

during whole blood donation

Amanda Thijsen, Jenny Fisher, Dr Barbara Bell

DH15-03 45 and Up: Blood Service data linkage project: a world-class donor

health data-asset

Dr Stephen Wright, Carley Gemelli, Dr Tanya

Davison, Prof David Irving

DH 15-05 Safety and feasibility of first appointment plasmapheresis donation Prof David Irving, Elizabeth Knight Dr Alison

Carver, Dr Tanya Davison, Dr Stephen Wright

Abandoned projects

DH15-02 Development of an Australian statistical model to predict

haemoglobin deferrals

Carley Gemelli, Dr Daniel Waller

Dr Stephen Wright


27

WE EXPLORE

WAYS TO PROCESS

BLOOD MORE

EFFICIENTLY,

IMPROVE STORAGE

LIFE AND

REDUCE WASTE

PRODUCT DEVELOPMENTAND STORAGEThe Blood Service strives to deliver safe, high

quality blood products whilst providing value for

our stakeholders. Product development and storage

research investigates novel ways to manufacture or

store blood components to maximise the donation

potential; create efficiencies and reduce waste;

improve component quality or shelf-life; and meet

the clinical demand for blood components.


28

Members of this team work closely with other Blood Service divisions as well as with external collaborators from universities and other institutions to conduct research that is focused on blood component development and quality, donor and product safety and improvements in operational efficiency.

Conventional components

Projects in this theme focus on gaining further knowledge and improving our current components, or ‘doing what we do better’. This research area investigates opportunities to improve the quality of our current components, or make collection and processing methods more efficient.

We have now accumulated two years of data from the Quality Monitoring Program from extended testing of each component (platelets, plasma and red cells) from all four Blood Service processing centres (Sydney, Brisbane, Melbourne and Perth). This a very rich source of data, particularly for parameters that are not monitored during routine quality control. The data will enhance our understanding of our blood components and will be analysed and shared with the Manufacturing and Quality teams.A joint R&D and Manufacturing project

evaluating a new plasma collection platform was conducted this year. This collaboration provided an opportunity for a Manufacturing team member from interstate to spend time in the Sydney R&D laboratory and better understand our processes and assays.

Dr Denese Marks led an international initiative to understand international practice in serum eye drop processing. She submitted a survey through the Biomedical Excellence for Safer Transfusion (BEST) Collaborative which was extremely well received, with over 37 responses from blood centres, hospitals and clinics throughout the world. A summary of the data was presented at the BEST meeting in October 2015, and will be presented at the upcoming AABB conference in Orlando in October 2016.

Outcomes from projects in this theme provide knowledge and data that can be used to improve production efficiencies and the storage conditions of blood components within the Blood Service. In addition, research in this area contributes to knowledge in the broader blood sector through publications, presentations at international meetings, and collaborations with other blood services around the world.

Extended component storage

Projects in this theme focus on developing strategies to extend the shelf-life of blood products. Of particular interest is the cryopreservation and cold storage of blood products. It is essential to understand any biochemical and functional alterations occurring in the cells within blood components, as a result of cryopreservation or refrigeration, to determine how these changes may influence their clinical utility.

Cryopreservation is an attractive alternative for blood product storage, as it enables a considerable extension of the product shelf-life, compared with liquid storage. This research encompasses the cryopreservation of both platelets and red cells. In addition, alternatives such as refrigerated storage of platelets and anaerobic storage of red cells are of interest.

During 2015-2016, work carried out by Dr Lacey Johnson and her team found that platelets stored in the refrigerator, rather than at room temperature, retain their ability to stimulate clotting activity for up to 21 days (see Research highlights, page 31).

Dr Lacey Johnson, in collaboration with Dr Larry Dumont from Dartmouth, is leading a study under the auspices of the Biomedical Excellence for Safer Transfusion (BEST) to evaluate additive solutions for reconstitution of cryopreserved platelets. The study has participants from the USA, New Zealand, Scotland, the Netherlands and Singapore.

Processes for preparing frozen red cells, platelets and plasma have been successfully transferred to the Manufacturing division of the Blood Service. As a result, an inventory of frozen blood products is now being manufactured for the ADF.

Novel products

This research develops and characterises novel products that are derived from our current blood components, or completely new products and therapies that have not been previously explored by the Blood Service. These products are developed to meet an unmet clinical demand and have the potential to improve patient outcomes. The major focus of this work is creating value from expired platelets by transforming them into new, valuable products, known as platelet lysates and platelet gels. Platelet lysate has been identified as a potential growth supplement for the production of human cells intended for therapeutic use. Platelet gels have potential therapeutic uses in wound healing.

Significant progress has been made with the development of a platelet lysate product. Dr Celine Loh has established new collaborations with researchers at the Royal Prince Alfred Hospital, Royal Perth Hospital and Sydney Eye Hospital, to examine the suitability of platelet lysates as a supplement for the propagation of human stem cells and for storage of corneal tissue.


30

PROJECTSTable 5: Product development and storage projects by theme. This table shows project titles and Blood Service investigators. Our external collaborators are shown in Appendix 5.

Conventional componentsCompleted projects

PD 14-02 New packaging system for serum eye drops Dr Joanne Tan, Dr Denese Marks

PD 14-03 Evaluation of automated red cell washing Dr Celine Loh, Dr Rena Hirani,

Dr Denese Marks

Ongoing projects

PD 14-01 Quality Monitoring Program (QMP) Dr Denese Marks, Dr Ryan Hyland

PD 15-01 Extending the shelf life of FFP and cryoprecipitate Dr Kelly Winter, Dr Denese Marks

PD15-02 Evaluation of new plasmapheresis systems Dr Kelly Winter, Dr Denese Marks

Extended component storageOngoing projects

PD14-04 Characterisation of cryopreserved platelets Dr Lacey Johnson, Dr Denese Marks,

Dr John-Paul Tung, Dr Melinda Dean

PD14-05 Cold storage of platelets Dr Lacey Johnson, Dr Denese Marks

PD14-06 Frozen blood stability testing Dr Lacey Johnson, Dr Denese Marks,

Dr Janet Wong

PD14-07 Improvements to red cell cryopreservation Dr Kelly Winter, Dr Lacey Johnson,

Dr Denese Marks

PD14-08 Anaerobic red cell storage Dr Joanne Tan, Dr Denese Marks

PD15-03 Use of additive solutions for reconstitution of cryopreserved platelets Dr Lacey Johnson, Dr Denese Marks

PD 15-04 Biomimetic blood bag materials for prolonged platelet storage Prof. David Irving, Dr Lacey Johnson,

Dr Denese Marks

PD 15-07 Evaluation of TRIMA plasma for reconstitution of cryopreserved

platelets for the ADF

Dr Lacey Johnson, Dr Denese Marks,

Dr Barbara Bell, Noemi Bondar

Novel productsOngoing projects

PD14-09 Development and characterisation of platelet lysates Dr Celine Loh, Dr Denese Marks

PD14-10 Development and characterisation of platelet gels Dr Celine Loh, Dr Denese Marks

Abandoned projects

PD 15-06 Development of a pooled buffy-coat-derived granulocyte product Dr Denese Marks, Dr Peta Dennington

01

RETHINKING PLATELET STORAGEPlatelets are routinely stored with agitation at room temperature for 5 days, after which they are discarded if they have not been transfused. Currently up to 20 percent of platelets are discarded prior to transfusion due to this short shelf-life. This practice is based on evidence from the 1970s that cold-stored platelets (ie platelets that had been stored in the refrigerator) were rapidly removed from the circulation after transfusion.

More recent research has shown that despite more rapid clearance, cold-stored platelets may be more functional and even offer advantages in some situations, such as trauma. Cold storage of platelets would also simplify storage and transport logistics.

In the last 12 months, a detailed comparison of conventional, cold-stored and cryopreserved platelets has been conducted within R&D, led by Principal Research Fellow, Dr Lacey Johnson. The study showed that many of the clot-forming functions of cold-stored platelets were just as good, if not better, than platelets stored conventionally at room temperature.


32

• confirmed the recent discovery of the August blood group (At), and shown that antibodies to the August antigen are clinically significant

• been announced as partners in a successful $4.3 million bid for an Industrial Transformation Training Centre, funded by the Australian Research Council (see highlights page 7). The successful partnership builds on an existing relationship with the Australian Institute for Biotechnology and Nanotechnology (AIBN) in Queensland, and will carry out research into new diagnostics and therapies.

Research in the Product safety group is divided into seven themes, described in more detail below. The themes are:

• Transfusion transmitted infections and emerging risks

• Reducing the risks associated with transfusion• Reducing the risk of TRALI• Understanding the pathogenesis of

adverse transfusion reactions: role of the immune system

• Identifying factors leading to the failure of red blood cell structure and function

• Optimising transfusion support for neonates at risk of Hemolytic Disease of the Newborn

• Development of applications of modern genotyping technology to provide a full blood group profile for donors and patients.

Transfusion transmitted infections and emerging risks

Emerging risks, including those with an infectious origin, can pose a risk to transfusion safety either directly, if they can be transmitted to a recipient in donated blood or indirectly, where outbreaks reduce the pool of available donors and decrease the available blood supply.

Research scientists in this team 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; how to improve the matching of donors and patients; and ensuring the risk of infectious disease transmission is maintained at as low a value as possible.

They harness massively parallel sequencing to solve previously unsolvable blood group incompatibilities by probing the genome for changes that affect the more than 35 known blood group systems. This research helps us provide appropriate transfusion support for people with rare blood types and leads to a greater understanding of diversity within the modern Australian population.

The Product safety group has particular expertise in the quantification of risk to ensure the safety of blood components. Members of the team work closely with national and international collaborators from hospitals and universities as well as with staff from other Blood Service Divisions.

During this reporting period, our researchers have

• carried out evaluations of the prevalence of Hepatitis E and Ross River viruses in the Australian donor population

• transferred the technology for non-invasive prenatal assessment of fetal blood type to the red cell reference laboratory within the Manufacturing division

The Product safety research group conducts

research to ensure the continuing safety of

our blood components and to improve the

understanding of the clinical effects of transfused

blood and blood products.

PRODUCT SAFETY


33

Due to globalization and increased international travel, many transfusion risks have become global. However, unique region-specific concerns exist. This research investigates possible risks to the Australian blood supply, by combining sero-epidemiological, donor demographic data and modelling approaches to provide evidence for assessing risk. This allows the development of appropriate management strategies for future -proofing our blood supply with respect to these emerging threats.

This year the team has continued to generate evidence in relation to whether hepatitis E virus (HEV) poses a risk to the Australian blood supply, and has shown that countries where donations are restricted following travel account for the majority of diagnosed overseas-acquired HEV cases in Australia. This suggests that the potential for transfusion-transmitted HEV from overseas-acquired HEV in Australia is adequately managed by existing travel policies. The team has also conducted a study on the prevalence of HEV RNA in blood donations, finding one in 14,799 donations were positive for HEV RNA. Given the low prevalence of viraemia found in this study, an additional study is being undertaken on 75,000 whole blood donations to provide data to more accurately model the risk of transfusion-transmitted HEV in the Australian population.

With the emergence of Zika virus globally, and recent reports of likely transfusion-transmission, the team is undertaking research to determine the probability of Zika virus transmission in Australia and the impact on blood safety. Although this research project is in its early days, the team has already demonstrated that, without vector control programs, Cairns and Townsville would have been suitable for Zika virus transmission throughout the year 2015.A group of technologies known as pathogen inactivation use ultraviolet light, either alone or with a photosensitising agent, 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 technology.


34

Reducing the risks associated with transfusion

Blood transfusion is essential to modern medicine. However, it is not without risk and transfusion has been associated with an increased risk of illness and death in certain patient groups. This research uses laboratory and animal models to understand whether transfusion is associated with poor clinical outcomes, and whether the storage time and conditions of the blood products contribute to these outcomes. Additionally, this research theme aims to develop an understanding of the mechanisms underlying such transfusion related adverse outcomes.

Reducing the risk of TRALI

Despite the introduction of risk-reduction strategies, transfusion-related acute lung injury (TRALI) is still a significant cause of morbidity and mortality following transfusion of blood products. TRALI may be caused by antibodies that target the patient’s white blood cells or by molecules known as biological response modifiers (BRMs). These molecules accumulate in blood products during routine storage and include lipids and proteins. Current risk reduction strategies focus on antibody-mediated TRALI (for example leucodepletion, male only clinical plasma); but no such strategies exist to combat the risk of TRALI caused by biological response modifiers. This group of projects is aimed at providing a better understanding of the mechanisms by which TRALI develops, especially TRALI caused by biological response modifiers. This increased knowledge will provide opportunities to develop new strategies to improve patient safety.

Understanding the pathogenesis of adverse transfusion reactions – role of the immune system

There is growing awareness in the medical community of the risks associated with transfusion, especially of stored blood products. A number of international and domestic clinical trials are underway to investigate poor patient outcomes associated with transfusion. Blood Service research in this area combines laboratory models of transfusion with studies of clinical samples from transfusion recipients to examine the mechanisms that lead to adverse


35

transfusion reactions. The team has developed a number of relevant transfusion models and has made significant contributions in this important area of transfusion medicine.

Identifying factors leading to failure of red blood cell structure and function

Storage of blood products is an essential aspect of modern blood banking practice, yet it is known that storage of blood products leads to changes in the product. There is also variation in the quality of product obtained from different donors, or from the same donor at different times. This research uses laboratory and animal

models of red blood cell structure to improve our understanding of the changes in blood products that can affect the outcome for patients. These parameters related to the blood product itself combine with underlying recipient factors to contribute to the patient outcomes after transfusion. Research in this area investigates these parameters by applying leading edge techniques to characterise changes in blood products, ultimately to inform changes in blood product safety and improve patient outcomes.

As a result of the work carried out in this theme our researchers designed a project that contributed to the successful award of the ARC Training Centre for Biopharmaceutical Innovation (see page 7).


This work was presented by Prof Robert Flower at the recent African Society of Blood Transfusion conference in Rwanda. Further extended presentations will be made by A/Prof Catherine Hyland at the International Society of Blood Transfusion conference in Dubai in September, 2016.

Improving identification of blood groups by genotyping

This research area explores options for blood donor genotyping using high-throughput technologies. This enables the Blood Service to provide appropriately matched blood for the increasingly diverse Australian population. In 2015 a new blood group system called the At or August system was discovered in African populations by French and English researchers.This is the 35th blood group system to be discovered since Dr Karl Landsteiner described the ABO blood group system in 1900.

Before the announcement of this discovery, our research group applied a leading edge genetic technology (called MPS for short) to study an antenatal patient of African background who presented with a clinically significant red cell antibody. The patient was in her fifth pregnancy and carrying twins. We found that she carried a very small change in a red blood cell surface protein that is now classified as the Augustine (AUG) blood group system. This provided an explanation for the patient’s antibody which formed as a result of exposure to red cells from the patient’s baby(s) from a previous pregnancy. The findings provided evidence to support the classification of the Ata blood antigen in the AUG system and showed its clinical significance for pregnant women. It will assist in improving donor patient matching, and in the management of pregnancies where there may be an incompatibility between the blood groups of the mother and baby.

At the time we made these findings there was no Augustine blood group system – there was the Augustine (or August) antigen (Ata) that was not assigned to a blood group. Our work confirmed the protein in which this antigen was located, using a “rare diseases” genetic approach, and that this was a new blood group system. These findings were presented by Prof Flower at the regional International Society for Blood Transfusion congress in London and also presented in the Presidential Symposium for the ANZSBT annual congress in Adelaide.

Optimising transfusion support for neonates at risk of Hemolytic Disease of the Newborn

Babies who develop hemolytic disease of the newborn (HDN) can become sick and die as their red blood cells are destroyed by antibodies from their mother’s blood. A number of red cell antibodies can cause this condition, but the most common case is when an Rh negative mother develops antibodies that react with the blood of an Rh positive fetus.

Early identification of the fetal blood group can assist in appropriate management of these pregnancies. The R&D team has developed a non-invasive prenatal test that can determine the fetal blood group from a sample of the mother’s blood. The test, known as NIPA (non-invasive prenatal analysis), replaces an existing test which relies on the invasive sampling of amniotic fluid. This year, the testing technology was transferred from R&D into the red cell reference laboratory to enhance the quality of service provided by the Blood Service for high risk RhD negative pregnant women.

A diverse array of blood group variants is found in the Australian population and some are associated with African and with East Asian population groups. Non-invasive fetal blood typing has been shown to be capable of managing the population variants that we have detected in both the patient and donor populations, including variants found in these population groups.


37

WE IDENTIFY

CURRENT AND

EMERGING RISKS

AND DEVELOP WAYS

TO MEASURE AND

CONTROL THEM


38

PROJECTSTable 6: Product safety research projects by theme. This table shows project titles and Blood Service investigators. Our external collaborators are shown in Appendix 5.

Transfusion transmitted infections and emerging risksCompleted projects

PS 14-01 Does hepatitis E virus pose a risk to the Australian blood supply? Dr Helen Faddy, Ashish Shrestha, Jesse Fryk,

Dr Clive Seed, Dr Anthony Keller,

Dr Mark Chan, Dr Robert Harley, Sue Ismay,

Prof Robert Flower

PS 14-03 The first integrated multimodal assay for the ultrasensitive detection of

dengue contamination of blood

Dr Helen Faddy, Thu Tran, Prof Robert Flower,

Prof David Irving

PS 14-06 Detection of Ross River virus in Australian blood donations Dr Helen Faddy, Prof Robert Flower, Thu Tran,

Jesse Fryk, Dr Clive Seed, Dr Veronica Hoad,

Dr Mark Chan, Dr Robert Harley, Dr Tony Keller

Ongoing projects

PS14-02 Q fever: how common is it, who is at risk and what does this mean for blood

safety?

Dr Helen Faddy, Thu Tran, Prof Robert Flower

PS14-04 Exotic mosquito-borne virus threats to Australia (including WNV, CHIKV, LNV

etc.):disease burden and consequences for blood supply safety

Dr Helen Faddy, Dr Clive Seed, Elise Hewlett,

Prof Robert Flower

PS14-05 TTI Safety: Emerging risks - what can our existing data tell us? Dr Helen Faddy, Dr Melinda Dean, Dr Clive

Seed, Dr Veronica Hoad, Dr Robert Harley,

Prof Robert Flower

PS15-01 Chikungunya and/or Zika virus emergence and establishment in Australia Dr Helen Faddy, Prof. Robert Flower,

Dr Elvina Viennet, Dr Clive Seed

PS15-02 Is parvovirus B19 a concern for the blood safety in Australia? Dr Helen Faddy, Prof Robert Flower,

Elise Gorman, Dr Tony Keller, Dr Mark Chan,

Dr Chris Hogan, Dr Veronica Hoad

Reducing the risk of TRALIOngoing projects

PS14-07 TRALI - Impact of leucodepletion on platelets Dr John-Paul Tung, Gabriela Simonova, Sanne

Pedersen, Arlanna Esguerra-Lallen, Dr Jo Pink

PS14-08 Investigating antibody and non-antibody mediated TRALI using laboratory

models

Dr John-Paul Tung, Dr Melinda Dean, Annette

Sultana, Gabriela Simonova, Emily McDonald,

Dr Jo Pink

PS14-09 Investigating levels of BRMs in donors implicated in clinical cases of TRALI Dr John-Paul Tung, Dr Melinda Dean,

Gabriela Simonova, Annette Sultana,

Htet Htet Aung, Dr Shoma Baidya, Kathryn

Goodison, Rhonda Holdsworth, Gail Pahn,

Mark Burton, Greg Jones, Penny Hassell,

Katie Havelburg, David Mahon


39

Reducing the risk of TRALI (cont.)Ongoing projects

PS15-03 Modification of the ovine model to make it more robust Dr John-Paul Tung, Gabriela Simonova,

Annette Sultana, Sanne Pedersen,

Arlanna Esguerra-Lallen, Emily McDonald

PS15-04 Development of ovine laboratory models of transfusion and TRALI Dr John-Paul Tung, Gabriela Simonova,

Annette Sultana, Emily McDonald

PS15-05 Extracellular traps and TRALI: more than just neutrophils Dr Melinda Dean, Dr John-Paul Tung,

Annette Sultana, Dr Zofia Perkowska-Guse

Reducing the risk associated with transfusionOngoing projects

PS14-10 Using a sheep model to understand the effects of transfusion

in severe trauma (CHORuS)

Dr John-Paul Tung, Gabriela Simonova,

Susan Blinkhoff

PS14-11 Using a sheep model to investigate transfusion of patients

with septic shock. (RESUS)

Dr John-Paul Tung, Gabriela Simonova,

Annette Sultana, Sanne Pedersen,

Arlanna Esguerra-Lallen

Understanding the pathogenesis of adverse transfusion reactions-role of the immune systemOngoing projects

PS 14-12 Impact of transfusion on dendritic cell function Dr Melinda Dean, Katrina Ki, Fenny Chong,

Dr Helen Faddy, Dr Lacey Johnson,

Prof Robert Flower

PS14-13 Transfusion associated immunomodulation in a cohort of cardiac patients

– translating laboratory findings to a clinical context

Dr Melinda Dean, Alexis Perros, Kelly Rooks,

Fenny Chong, Dr Helen Faddy,

Dr John-Paul Tung

PS 14-14 Do donor and/or processing associated parameters contribute to biological

variation in biological response modifiers in packed red blood cells?

Dr Melinda Dean, Kelly Rooks, Fenny Chong

Optimising transfusion support for neonates at risk of Hemolytic Disease of the NewbornCompleted projects

PS 14-15 Non-invasive assessment (NIPA) translation: for high risk pregnant women

who are allo-immunised to the RhD blood group antigen

A/Prof Catherine Hyland, Glenda Millard,

Helen O’Brien, Prof Robert Flower,

Sue Ismay, Tanya Powley

PS14-16 Reduction in anti-D immunoglobulin usage by genotyping:

a cost (and) benefit analysis

A/Prof Catherine Hyland, Glenda Millard,

Helen O’Brien, Eunike McGowan,

Prof Robert Flower, Dr Chris Hogan

PS14-17 Haemolytic disease of the foetus and newborn (HDFN) associated with blood

groups (other than RhD): Digital PCR for this “atypical” panel for blood group typing

A/Prof Catherine Hyland, Dr Elizna Schoeman,

Glenda Millard, Helen O’Brien, Prof Robert

Flower, Dr Yew-Wah Liew, Dr Chris Hogan


40

PROJECTS

Improving identification of blood groups by genotypingOngoing projects

PS 14-18 Genetic basis for blood groups A/Prof Catherine Hyland, Dr Elizna Schoeman,

Genghis Lopez, Helen O’Brien, Glenda Millard,

Eunike McGowan, Prof Robert Flower,

Dr Yew-Wah Liew; Dr Chris Hogan

PS14-19 What is the risk of alloimmunisation by transfusion of variant RhD

red blood cells that serotype as RhD Negative?

A/Prof Catherine Hyland, Eunike McGowan,

Dr Elizna Schoeman, Genghis Lopez, Glenda

Millard, Prof Robert Flower, Dr Melinda Dean,

Tanya Powley, Dr Chris Hogan

PS14-20 Building capacity to solve complex red cell serology using genetic sequencing Dr Helen Faddy, Dr Melinda Dean, A/Prof

Catherine Hyland, Dr Elizna Schoeman, Glenda

Millard, Helen O’Brien, Genghis Lopez, Eunike

McGowan, Prof Robert Flower, Tanya Powley,

Dr Chris Hogan, Dr Clive Seed, Dr Veronica

Hoad, Dr Robert Harley, Prof Robert Flower

PS15-06 Red cell alloimmunisation: How can extended genotyping support

the ongoing transfusion needs of haemoglobinopathy patients?

A/Prof Catherine Hyland, Dr Elizna Schoeman,

Glenda Millard, Helen O’Brien, Genghis Lopez,

Dr Rena Hirani, Prof Robert Flower,

Prof David Irving

Identifying factors leading to failure of RBC structure and functionCompleted projects

PS 14-21 Modelling genetic risks for poor red cell storage Dr Melinda Dean, Katrina Kildey, Fenny Chong,

Kelly Rooks, Robert Flower

Ongoing projects

PS 14-22 Cellular processes that regulate the lifespan of red blood cells Dr Melinda Dean, Kelly Rooks,

Prof David Irving, Prof Robert Flower

PS 15-07 Points of structural failure that may lead to storage-related

changes of red cells

Prof. Robert Flower, Dr Helen Faddy, Marie

Anne Balanant, Sarah Barns, Amelie Babinet


41

HOW MECHANICAL ENGINEERS SEE RED BLOOD CELLSMechanical engineers are using skills normally applied to engineering problems to help us understand more about the human body. Our researchers have joined forces with mechanical engineers at the Queensland University of Technology to model the red blood cell.

During its 120-day lifetime, each of your red blood cells completes around 170,000 circuits of your body, travelling around 500km. During each circuit a red blood cell needs to squeeze through tiny capillaries where it can deliver oxygen to the surrounding tissues. It’s a remarkable feat, and one that becomes more difficult for older blood cells, especially those that have been stored outside the body before a transfusion.

“Red blood cells become less flexible as they age,” explains the Blood Service’s Professor Robert Flower.

“They also change from their flattened disc shape to a spherical shape which doesn’t function as efficiently. When we store blood for transfusion, these changes happen more quickly than they do in the body. Understanding what triggers the changes may help us find ways to make stored blood last longer.”

These changes suggest that something has changed in the network of molecules that supports the cell. Structural supports and changes in flexibility are areas that engineers understand really well. This is where the unlikely alliance between researchers at the Blood Service and mechanical engineers at Queensland University of Technology comes into play. Together, their work will bring greater insight into the changes in flexibility of red blood cells.

The researchers are using computer modelling methods to develop a mathematical model of red blood cells. The computer model describes the shape and physical behaviour of red blood cells, using the concept of a network of springs and anchors inside a flexible casing, which represents the membrane that surrounds the red blood cell.

Professor Flower and his team are working with Professor YuanTong Gu and colleagues from the School of Chemistry, Physics and Mechanical Engineering at Queensland University of Technology on the project, which is funded by a grant of $350,000 from the Australian Research Council. Doctoral candidates Sarah Barns and Marie Anne Balanant are working on two sides of the project, with Sarah developing the theoretical model, and Marie Anne testing its predictions in a laboratory setting.

The computer model will be used to predict real world outcomes that may be difficult to test otherwise, for example, how red blood cells could flex and squeeze through a narrow capillary. In the future it may help us to select storage solutions that will keep your blood cells fresh for longer after you have donated them.

PRODUCT USAGEThe Product usage research team covers a number

of areas: finding the right product for the patient at

the right time; ensuring appropriate clinical usage

of blood products; and understanding the molecular

mechanisms associated with blood transfusion.

The knowledge gained will provide data on whether

the most effective transfusion practice is being

used to improve patient outcomes, identify the most

effective products for certain clinical settings and

understand the usage for products that are in high

demand, such as O Rh(D) negative red cells.


Projects within Product usage fall within four themes:

• Clinical trials of novel products• Clinical trials of conventional products• Optimising product usage• Data linkage

Projects underway in this theme are shown in Table 7 on page 44.

Optimising product usage

Despite a decreasing demand for red cells worldwide, the demand for O Rh(D) negative red cells continues unabated, and now represents almost 16% of total red cell demand in Australia. Given that only nine percent of the donor pool are O Rh(D) negative, this group requires particular attention to maintain a balance between supply and demand. An extensive study of the fate of O Rh(D) negative blood units has been conducted this year, tracking the usage of all units nationally over a five week period. The findings will assist in the development of policies and inventory management procedures both within the Blood Service and in hospital settings,

to ensure the most effective use of this precious resource (see Research highlights, page 45).A presentation based on the findings of the retrospective donor leucocyte survival (microchimerism) study completed in 2014-15 was selected for a presentation in the ANZSBT presidential symposium for the annual meeting of HAA. Studies of microchimerism will be expanded in the new year, with a new post graduate student analysing the incidence of donor leucocyte survival (microchimerism) in chronically transfused patients.

Clinical trials of novel products

To extend our knowledge of the ability of frozen platelets to stop bleeding in patients, the Blood Service is participating in a clinical trial of frozen platelets (the “CLIP” trial), in collaboration with researchers from the University of Queensland. The randomised, double blinded study is comparing the feasibility of use and clinical effectiveness of frozen platelets with fresh, liquid-stored platelets that have not been frozen in patients undergoing cardiac surgery. Screening and enrolment of cardiac patients is underway at two of three hospital sites. To date 45 patients have been randomised to the trial, and of these, 25 have been enrolled and received a transfusion.

Outcomes from the trial will provide valuable data to support the possible use of frozen platelets in non-military hospitals in the future.

Clinical trials of conventional products

Despite the history of blood transfusion, red blood cell transfusion is associated with adverse events in some critically ill patients. Systematic reviews to date have provided conflicting or inconclusive results on whether the length of red cell storage impacts on outcomes for patients. The Blood Service is a partner in a 42


large, randomised controlled trial funded by an NHMRC Project grant (the TRANSFUSE study) to examine the effect of age of blood transfused on patient outcomes. Recruitment has continued, with over 4300 of the target of 5000 patients enrolled in the study as of June 30, 2016.

Data linkage

This theme consists of a number of collaborative projects that aim to improve policy and practice through analysing existing and prospective data related to blood product usage and patient outcomes. During 2015-2016, our researchers and their collaborators at the Kolling Institute and the Clinical Excellence Commission completed a four year study to improve the medical treatment of mothers who bleed during childbirth. The study will help doctors better identify when, and to whom, they should give blood transfusions. The study looked at whether the quantities of blood given are appropriate, that blood is given under the right conditions, and what the outcomes are of those transfusions. By understanding how blood is being used in this situation, we can contribute to informing guidelines for clinical practice. A second NHMRC grant has been awarded based on these results, allowing the researchers to examine further questions with the data already gathered.

43

WE ANALYSE HOW BLOOD

PRODUCTS ARE USED SO

WE CAN PROVIDE THE

RIGHT PRODUCT FOR

EVERY PATIENT

PROJECTS


44

Table 7: Product usage research projects by theme. This table shows project titles and Blood Service investigators. Our external collaborators are shown in Appendix 5.

Optimising product usageCompleted projects

PU 14-01 Validation of candidate immune biomarkers as predictors of IVIg response

in CIDP patients to promote cost-effective IVIg dosing.

Dr Wayne Dyer, Dr Joanne Tan, Dr Janet Wong,

Dr Phillip Mondy

Ongoing projects

PU14-02 Blood product safety in massive transfusion recipients

- Does white cell filtration really remove transfusion risk?

Dr Rena Hirani, Dr Wayne Dyer,

Dr Phillip Mondy

PU15-01 To review the use of O negative red cells, cryoprecipitate

and washed red cells nationally.

Dr Rena Hirani, Prof David Irving

Clinical trials of novel productsOngoing projects

PU14-03 Clip Trial - Cryopreserved versus Liquid Stored Platelets for surgical bleeding Dr Denese Marks, Dr Lacey Johnson,

Prof David Irving

PU14-04 A clinical trial assessing the efficacy and safety of allogeneic serum

eye drops in severe dry eye patients

Dr Denese Marks, Dr Joanne Tan,

Dr Peta Dennington, Prof David Irving

PU14-05 A Phase III prospective, randomised, double-blinded multicentre clinical

trial on clinical efficacy and safety of platelet concentrates treated with the Theraflex

UV-Platelets system in comparison to conventional platelet components

Dr Denese Marks, Dr Lacey Johnson,

Prof David Irving, Dr Peta Dennington

Clinical trials of conventional productsOngoing projects

PU 14-06 TRANSFUSE - Standard Issue Transfusion versus fresher red blood

cell use in intensive care - a randomised controlled trial

Prof David Irving and Dr Philip Mondy

(Associate Investigators and members

of the project Management Committee)

PU14-07 TRANSFUSE Sub Study - Investigating the effects of the age of transfused

red cells on haemolysis and iron metabolism in critically ill patients

Dr Melinda Dean, Prof Robert Flower, Dr Chris

Hogan, Shauna French, Prof David Irving

Data linkageOngoing projects

PU 14-08 Exploring the impact of blood transfusion on maternity outcomes

and healthcare utilisation: informing the use of blood and blood products

in the obstetric setting

Prof David Irving, Dr Janet Wong

PU 14-09 Transfusion Outcomes Research Collaborative II (TORC II) Prof David Irving, Prof Robert Flower, Dr Chris

Hogan (TORC II Steering Committee members)

PU 14-10 Massive Transfusion registry Prof David Irving, Prof Robert Flower, Dr Chris

Hogan (TORC II Steering Committee members)

01

BETTER MANAGEMENT OF THE BLOOD SUPPLY While overall demand for red cells is decreasing, there is a progressive increase in the proportion of red cells which are O Rh(D) negative that are being supplied to health providers. Our O Rh(D) negative donors are being asked to give more frequently than anyone else, since these donors, who make up only nine percent of the population, are supplying more than 15 percent of our red cell demand. So how are these O Rh(D) negative units being used? Where does it all go?

To understand what is causing this demand, our research team surveyed the fate of group O Rh(D) negative red blood cell units issued to all approved Australian health providers within a five week period in 2015. We wanted to find out if the growing demand for this blood type was due to unavoidable changes in transfusion practice or whether there is something that can be modified to reduce the demand.

The survey response gathered data on over 6000 units that were transfused into approximately 3000 patients. The largest avoidable use of O negative units was transfusing them because they were close to expiry, which accounted for almost a quarter of total usage.

We are using the survey results to guide conversations with clinicians and blood bank scientists to develop ways to minimise wastage and manage hospital inventory more effectively while still meeting patients’ needs.

APPENDIX 1


46

Publications and invited presentationsPeer reviewed journal articles

Publications which have been epublished ahead of print during the reporting period, 1 July 2015-30 June 2016 are indicated in italics. These items will also appear in print in the following reporting period. Blood Service authors are shown in bold.

Donor behaviourBagot KL, Murray AL, Masser BM How can we improve retention of the first-time donor? A systematic review of the current evidence.

Transfusion Medicine Reviews, 2016 30 (2), 81-91.

Bagot, KL, Masser BM, Starfelt LC, White KM Building a flexible, voluntary donation panel: An exploration of donor willingness.

Transfusion, 2016 56 (1), 186-194.

Bagot KL, Masser BM, White KM Using an Extended Theory of Planned Behavior to Predict a Change in the Type of Blood Product

Donated. Annals of Behavioral Medicine, 2015 49 (4), 510-521.

Chell K, Waller D, Masser B. The blood donor anxiety scale: A six-item state anxiety measure based on the Spielberger State-Trait

Anxiety Inventory. Transfusion, 2016, 56 (6pt2), 1645-1653.

Masser B, France CR, Foot J, Rozsa A, Hayman J, Waller D, Hunder E Improving first-time donor attendance rates through the use of

enhanced donor preparation materials. Transfusion, 2016 56 (6), 1628-1635.

Masser B, Bove LL, White KM, & Bagot KL. Negative experiences and donor return: An examination of the role of asking for something

different. Transfusion 2016 56, 605-613.

Masser B. & Bagot KL Plasmapheresis: Recruitment, retention, and flexible donors. ISBT Science Series 2015 10(S1), 268-274.

Waller D, Thijsen A, Garradd A, Hayman J, Smith G (2015) Donating blood for research: a potential method for enhancing customer

satisfaction of permanently deferred blood donors. Blood transfusion = Trasfusione del sangue:1-7

Donor health and wellbeingBentley P, Bell B, Hoad V. & Pathak P The High Ferritin App: electronic referral to the Australian Red Cross Blood Service for

therapeutic venesection. Transfus Med 2015 25(4), 280-281.

Bentley P, Bell B, & Olynyk J Therapeutic venesection at the Australian Red Cross Blood Service: impact of the High Ferritin Application

on management of hereditary haemochromatosis. Aust Fam Physician, 2015 44(8), 589-592.

Mondy P, Brama T, Fisher J, Gemelli CN, Chee K, Keegan A, Waller D. Sustained Benefits of Autologous Serum Eye Drops on

Self-reported Ocular Symptoms and Vision-related Quality of Life in Australian Patients with Dry Eye and Corneal Epithelial Defects.

Transfusion and Apheresis Science 2015, Dec;53(3):404-11.

Thijsen A, King A, Waller A. Lost in translation: Knowledge, attitudes and practices in donors experiencing a recent vasovagal reaction.

Transfusion and Apheresis Science 2016, Jun 54(3), 384-9.

Waller, D, Mondy, P, Brama T, Fisher J, King A, Malkov K, Wall-Smith D, Ryan L, Irving DO, Determining the effect of vein

visualisation technology on donation success, vasovagal symptoms, anxiety and intention to re-donate in whole blood donors aged

18-30 years: A randomised-controlled trial. Vox Sanguinis. Doi:10.1111/vox.12407. Epub 2016 May 11

APPENDICES

47

Product development and storageFarrugia BL, Chandresekar K, Johnson L, Marks DC, Irving DOI, Lord MS. Perspectives on the use of biomaterials to store platelets for

transfusion. Biointerphases 2016;11:029701. doi: 10.1116/1.4952450.

Johnson L, Tan S, Wood B, Davis A, Marks DC. Refrigeration and cryopreservation of platelets differentially affect platelet metabolism

and function: a comparison with conventional platelet storage conditions. Transfusion 2016. doi: 10.1111/trf.13630. Epub 2016 May 9

Johnson L, Schubert P, Tan S, Devine D, Marks DC. Extended storage and glucose exhaustion are associated with apoptotic changes in

platelets stored in additive solution. Transfusion 2016: 56: 360368.

Johnson L, Hyland RA, Tan S, Tolksdorf F, Sumian C, Seltsam A, Marks DC. In vitro quality of platelets with low plasma carryover treated

with ultraviolet C light for pathogen inactivation. Transfusion Medicine and Hemotherapy 2016;43:190-197 DOI:10.1159/000441830

Marks DC, Fisher J, Mondy P, Segatchian J, Dennington PM. Serum eye drop preparation in Australia: current manufacturing practice.

Transfusion and Apheresis Science 2015; 53: 92-94.

Raynel S, Padula MP, Marks DC, Johnson L. Cryopreservation alters the membrane and cytoskeletal protein profile of platelet

microparticles. Transfusion 2015; 55: 2422-2432.

Sophocleous RA, Mullany PRF, Winter KM, Marks DC and Sluyter R. Propensity of red blood cells to undergo P2X7 receptor-mediated

phosphatidylserine exposure does not alter during in vivo or ex vivo aging. Transfusion 2015; 55:1946-1955.

Van der Meer PF, Seghatchian J, Marks DC. Quality standards, safety and efficacy of blood-derived serum eye drops: A review.

Transfusion and Apheresis Science 2016; 54: 164-167.

Winter KM, Johnson L, Webb RG, Marks DC. Gamma-irradiation of deglycerolised red cells does not significantly affect in vitro quality.

Vox Sanguinis 2015; 109: 231-238.

Product safetyFaddy HM, Flower RL, Seed CR, Ismay S, Ong E, Linnen JM, Cory R, Holmberg JA, Hall RA, Setoh YX, Deerain JM, Prow NA:

Detection of emergent strains of West Nile virus with a blood screening assay. Transfusion 2016 56(6 Pt 2): 1503-7

Goldman M, Cemborain A, Cote J, El Hamss R, Flower RL, Garaizar A, Garcia-Sanchez F, Hyland CA, Kalvelage M, Londero D, Lopez

GH, Revelli N, Rodriguez-Wilhelmi P, Villa A, Ochoa-Garay G: Identification of six new RHCE variant alleles in individuals of diverse racial

origin. Transfusion 2016; 56: 244-8.

Ki KK, Flower RL, Faddy HM, Dean MM. Incorporation of Fluorescein Conjugated Function-Spacer-Lipid constructs into the red blood

cell membrane facilitates detection of labelled cells for the duration of ex-vivo storage. Journal of Immunological Methods 2016; 429:

66-70.

Lancini DV, Faddy HM, Ismay S, Chesneau S, Hogan C, Flower RLP. Cytomegalovirus in Australian blood donors: seroepidemiology

and seronegative red blood cell component inventories. Transfusion. 2016; 56(6 pt 2): 1616-21.

Lopez GH, Wei L, Ji Y, Condon JA, Luo G, Hyland CA, Flower RL. GYP*Kip, a novel GYP(B-A-B) hybrid allele, encoding the MNS48

(KIPP) antigen. Transfusion 2016; 56: 539-41.

Lopez GH, Morrison J, Condon JA, Wilson B, Martin JR, Liew YW, Flower RL, Hyland CA. Duffy blood group phenotype-genotype

correlations using high-resolution melting analysis PCR and microarray reveal complex cases including a new null FY*A allele: the role

for sequencing in genotyping algorithms. Vox Sang 2015; 109: 296-303.

Lopez GH, McGowan EC, McGrath KA, Abaca-Cleopas ME, Schoeman EM, Millard GM, O’Brien H, Liew Y-W, Flower RL, Hyland CA.

A RhD-positive blood donor with a novel RHD*D-CE(5-6)-D gene variant exhibits the low frequency antigen RH23 (DW) antigen

characteristic of the partial DVa phenotype. Transfusion 2016; doi:10.1111/trf13713 Epub 2016 14-June-16

McBean RS, Wilson B, Liew YW, Hyland CA, Flower RL: Quantitation of Lan antigen in Lan+, Lan+(w) and Lan- phenotypes. Blood

Transfus. 2015;13: 662-5.

McBean RS, Hyland CA, Flower RL: Blood group genotyping: the power and limitations of the Hemo ID Panel and MassARRAY

platform. Immunohematology. 2015;31: 75-80.

APPENDIX 1


48

Peer reviewed journal articles (cont.)

Product safetyMcBean R, Liew Y-W, Wilson B, Kupatawintu P, Emthip M, Hyland C, Flower R: Genotyping confirms inheritance of the rare At(a−) type

in a case of haemolytic disease of the newborn. The Journal of Pathology: Clinical Research. 2016; 2: 53-5.

Mittag D, Sran A, Chan KS, Boland MP, Bandala-Sanchez E, Huet O, Xu W, Sparrow RL. Stored red blood cell susceptibility to in vitro

transfusion-associated stress conditions is higher after longer storage and increased by storage in saline-adenine-glucose-mannitol

compared to AS-1. Transfusion, 2015; 55(9), 2197-2206.

Nayanajith PGH, Saha SC, Sauret E, Flower RF, Gu Y Numerical investigation of motion and deformation of a single red blood cell

in a stenosed capillary. Int J Comput Methods 2015 12:1540003 doi:DOI: 10.1142/S0219876215400034

Ng MSY, Ng ASY, Chan J, Tung JP, Fraser JF. Effects of packed red blood cell storage duration on post-transfusion clinical outcomes:

a meta-analysis and systematic review. Intensive Care Medicine. 2015. 41(12): 2087-97.

Ngui SL, Brant L, Markov PV, Tung JP, Pybus OG, Teo CG, Ramsay ME. Hepatitis C virus genotype 4 in England: diversity and

demographic associations. Journal of Medical Virology. 2015. Mar; 87(3): 417-23.

Osthoff M, Dean MM, Baird PN, Richardson AJ, Daniell M, Guymer RH, Eisen DP; Association Studies of Mannose-Binding Lectin Levels

and Genetic Variants in Lectin Pathway Proteins with Susceptibility to Age-Related Macular Degeneration: A Case-Control Study. PLOS

one. 2015 Jul 24;10(7) e0134107

Perros A, Christensen AM, Flower RL, Dean MM. Soluble mediators in platelet concentrates modulate dendritic cell inflammatory

responses. Journal of Interferon and Cytokine Research 2015 35(10): 821-30.

Petrik J, Lozano M, Seed CR, Faddy HM, Keller AJ, Prado Scuracchio PS, Wendel S, Andonov A, Fearon M, Delage G, Zhang J, Shih JW,

Gallian P, Djoudi R, Tiberghien P, Izopet J, Dreier J, Vollmer T, Knabbe C, Aggarwal R, Goel A, Ciccaglione AR, Matsubayashi K, Satake

M, Tadokoro K, Jeong SH, Zaaijer HL, Zhiburt E, Chay J, Teo D, Chua SS, Piron M, Sauleda S, Echevarria JM, Dalton H, Stramer SL:

Hepatitis E. Vox sanguinis. 2015;110: 93-103.

Polwaththe-Gallage HN, Saha SC, Sauret E, Flower R, & Gu Y. (2015). A coupled SPH-DEM approach to model the interactions between

multiple red blood cells in motion in capillaries. International Journal of Mechanics and Materials in Design, 1-18.

Seed CR, Hoad VC, Faddy HM, Kiely P, Keller AJ, Pink J. Reevaluating the residual risk of transfusion-transmitted Ross River virus

infection. Vox Sanguinis 2016;110: 317-23.

Seed CR, Wong J, Polizzotto MN, Faddy H, Keller AJ, & Pink J. The residual risk of transfusion-transmitted cytomegalovirus infection

associated with leucodepleted blood components. Vox Sanguinis 2015 109(1), 11-17.

Wei L, Shan ZG, Flower RL, Wang Z, Wen JZ, Luo G. P., & Ji YL The distribution of MNS hybrid glycophorins with Mur antigen

expression in Chinese donors including identification of a novel GYP.Bun allele. Vox Sanguinis. 2016 doi: 10.1111/vox.12421

Young MK, Faddy HM, Fryk J, Nimmo GR, Cripps AW: Hepatitis A virus antibodies in Australian blood donors: Implications for

immunoglobulin sufficiency. Vaccine. 2015;33: 5135-9.

Waller, D, Mondy, P, Brama T, Fisher J, King A, Malkov K, Wall-Smith D, Ryan L, Irving DO, Determining the effect of vein visualisation

technology on donation success, vasovagal symptoms, anxiety and intention to re-donate in whole blood donors aged 18-30 years:

A randomised-controlled trial. Vox Sanguinis. Doi:10.1111/vox.12407. Epub 2016 May 11

APPENDICES

49

Product usageBowen JR, Patterson JA, Roberts CL, Isbister JP, Irving DO, Ford JB. Red cell and platelet transfusions in neonates: a population-

based study. Archives of disease in childhood: Fetal and neonatal edition 2015 100(5):F411-5

Crighton G., Wood AE., Scarborough R, Ho J, & Bowden AD. Haemoglobin disorders in Australia: where are we now and where will

we be in the future? Internal Medicine Journal 2016 doi: 10.1111/imj.13084

Crighton G, Estcourt LJ, Wood EM., & Stanworth SJ. Platelet Transfusions in Patients with Hypoproliferative Thrombocytopenia:

Conclusions from Clinical Trials and Current Controversies. Hematol Oncol Clin North Am, 2016 30(3), 541-560.

Crighton GL, Estcourt LJ, Wood EM, Trivella M, Doree C, & Stanworth S. A therapeutic-only versus prophylactic platelet transfusion

strategy for preventing bleeding in patients with haematological disorders after myelosuppressive chemotherapy or stem cell

transplantation. Cochrane Database Syst Rev, 2016 9, CD010981. doi: 10.1002/14651858.CD010981.pub2

Hirani, R, Balogh, ZJ., Lott, NJ, Hsu, JM and Irving, DO Leukodepleted blood components do not remove the potential for long-term

transfusion-associated microchimerism in Australian major trauma patients. Chimerism 2015 (3-4):86-93.

McQuilten, ZK, Andrianopoulos N, van de Watering L., Aubron C, Phillips L, Bellomo R., . . . Wood EM. (2015). Introduction of universal

prestorage leukodepletion of blood components, and outcomes in transfused cardiac surgery patients. J Thorac Cardiovasc Surg, 2015

150(1), 216-222.

Mraz GA., Crighton GL., & Christie DJ. Antibodies to human neutrophil antigen HNA-4b implicated in a case of neonatal alloimmune

neutropenia. Transfusion 2016 56 (5) 1161-5

Patterson JA, Irving DO, Isbister JP., Morris JM, Mayson E, Roberts CL., & Ford JB. Age of blood and adverse outcomes in a maternity

population. Transfusion 2015 55(11), 2730-2737.

Perera S, Wang B, Damian A, Dyer W, Zhou L, Conceicao V, Saksena N (2016). Retrospective proteomic analysis of cellular immune

responses and protective correlates of p24 vaccination in an HIV elite controller using antibody arrays. Microarrays; 5: 14.

Internal cross-disciplinary collaborations

Allison KM, Faddy HM, Margaritis A, Ismay S, Marks DC. The impact on blood donor screening for human immunodeficiency virus,

hepatitis C virus, and hepatitis B virus using plasma from frozen-thawed plasma preparation tubes. Transfusion 2016; 56: 449-456.

Faddy HM, Fryk JJ, Watterson D, Young PR, Modhiran N, Muller D, Keil SD, Goodrich RP, Marks DC. Riboflavin and ultraviolet light:

impact on dengue virus infectivity. Vox Sanguinis 2016. doi: 10.1111/vox.12414. Epub 2016 Jun 9.

Faddy HM, Fryk JJ, Prow NA, Watterson D, Young PR, Hall RA, Tolksdorf F, Sumian C, Gravemann U, Seltsam A, Marks DC. Inactivation

of dengue, chikungunya, and Ross River viruses in platelet concentrates after treatment with ultraviolet C light. Transfusion 2016;

56:1548-1555.

Loh YS, Dean MM, Johnson L, Marks DC; Pathogen reduction treatment and subsequent storage of buffy-coat derived platelets alters

production of monocyte inflammatory mediators in a whole blood transfusion model. Vox Sanguinis. 2015 Nov;109(4):327-35.

APPENDIX 1


50

Invited publications

Product development and storageMarks D and Johnson L. Are cryopreserved platelets just around the corner? Biopreservation Today (industry publication).

2015; 5(2):11-12.

Seghatchian J, Marks DC. A patient focused application of a non-conventional blood components- autologous serum eye drops

- and current opinions on substances used for clinical management of acute haemorrhage for shock/trauma. Editorial. Transfusion

and Apheresis Science 2016; 53:403.

Van der Meer PF, Eder AF, Marks DC. Turning the Page. Editorial. ISBT Science Series 2015; 10: 1

Johnson L, Raynel S, Seghatchian J, Marks DC. Platelet microparticles in cryopreserved platelets: potential mediators of hemostasis.

Transfusion and Apheresis Science 2015 Oct;53(2):146-52.

Product safetyFaddy HM, Viennet E, Flower RLP. Transfusion risk from emerging pathogens in the Asia-Pacific region. ISBT Science Series. 2016.

Volume 11 (Suppl. 2), 143-148.

Fung YL, Simonova G, Tung JP. Lessons from sheep models of transfusion. ISBT Science Series. 2016. Volume 11 (Suppl. 2), 73-78.

Peer reviewed published abstracts Donor behaviourGemelli CN, Thijsen A, Waller D, Hayman J. Frequent Whole Blood And Apheresis Donors: Understanding Characteristics And Return

Behaviour. In ‘Abstracts of the 26th Regional Congress of the International Society of Blood Transfusion in conjunction with the 6th

Annual Conference of The Indonesian Society of Transfusion Medicine, Bali, Indonesia, November 14–16, 2015’. Vox Sanguinis 2015,

109: Suppl S2, 1-101.

Thijsen, A, Gemelli, CN, Waller, D, Wright ST, Masser B. Factors Associated with Blood Donation in an Older Population: A Comparison

between Donors and Non-donors. In ‘Abstract Presentations from the AABB Annual Meeting Anaheim, CA, October 24–27, 2015’.

Transfusion. 2015, 55: 3A–245A.

Donor health and wellbeingGemelli CN, Thijsen A, Waller D, Wright ST, Masser B. Impact of Temporary Deferrals on Time to Return: Differences between Established

and Newly Frequent Blood Donors. In ‘Abstract Presentations from the AABB Annual Meeting Anaheim, CA, October 24–27, 2015’.

Transfusion. 2015, 55: 3A–245A.

Thijsen A, Waller D, O’Donovan J, Bell B. Delayed Vasovagal reactions following Blood Donation. In ‘Abstracts of the 26th Regional

Congress of the International Society of Blood Transfusion in conjunction with the 6th Annual Conference of The Indonesian Society

of Transfusion Medicine, Bali, Indonesia, November 14–16, 2015’. Vox Sanguinis 2015, 109: Suppl S2, 1-101.

Product development and storagede Korte D, Thibault L, Morrison A, Fitzpatrick A, Marks DC, Seltsam A, Acker J., On behalf of the Biomedical Excellence for Safer

Transfusion (BEST) Collaborative. Timing of gamma irradiation and sex of blood donor influences in vitro characteristics of red cell

concentrates Transfusion 2015; 55 (issue S3): 3A-255A.

Johnson L, Hyland R, Tan S, Marks DC A glucose-containing additive supports in vitro recovery of cryopreserved platelets after thawing.

Transfusion 2015; 55 (issue S3): 3A-255A

APPENDICES

51

Product development and storage (cont.)Johnson L, Hyland R, Tan S, Tolksdorf F, Sumian C, Seltsam A, Marks DC. Reduced plasma carryover has little effect on the in vitro quality

of platelets treated with ultraviolet C light for pathogen inactivation. Transfusion 2015; 55 (issue S3): 3A-255A.

Winter KM, Hyland R, Tan S, Fisher JE, Bondar N, Orr A, Marks DC. An assessment of apheresis plasma collected by using

the Haemonetics high-separation core. Transfusion 2015 55 (issue S3): 3A-255A.

Product safetyDean MM, Dunford M, Flower RL, Faddy HM. Biological markers of infection may assist in the identification of early stage viral infection

and serve as a surrogate biomarker to identify asymptomatic Ross River or Barmah Forest virus infection. Journal of Immunology; 2016;

196 (S1) 193.9

Dean MM, Luimstra J, Rooks K, Flower RL. Investigation of immune cell maintenance and function in MBL-sufficient and MBL-deficient

individuals. Journal of Immunology; 2016; 196 (S1) 124.36.

Faddy HM, Viennet E, Flower R. Transfusion Risk From Emerging Pathogens in the Asia-Pacific Region. Vox Sanguinis, Volume 109

(Suppl. 2), November 2015.

Faddy HM, Fryk JJ, Seed CR, Hyland C, Holmberg JA, Flower R. The Search for Dengue Virus in Australian Blood Donations During Local

Outbreaks. Vox Sanguinis, Volume 109 (Suppl. 2), November 2015.

Faddy HM, Fryk JJ, Young PR, Watterson D, Hall RA, Prow NA, Hobson-Peters J, Reichenberg S, Marks DC. Inactivation of Dengue

and Chikungunya Viruses With the Theraflex MB-Plasma System. Vox Sanguinis, Volume 109 (Suppl. 2), November 2015.

Shrestha AC, Flower RLP, Seed CR, Keller AJ, Hoad V, Harley R, Leader R, Polkinghorne B, Furlong C, Faddy HM. Hepatitis E Virus

Infections in Travellers: A Threat in Australia? Vox Sanguinis, Volume 109 (Suppl. 2), November 2015.

Shrestha AC, Flower RLP, Seed CR, Keller AJ, Harley R, Chan HT, Hoad V, Warrilow D, Holmberg JA, Faddy HM. Detection of Hepatitis E

Virus in Australian Blood Donations. Vox Sanguinis, Volume 109 (Suppl. 2), November 2015.

Invited external presentations Donor behaviourBarbara Masser Interview with Natalie Peters on radio station 2GB Brisbane to discuss National Blood Donor Week, 12 June 2016.

Available at http://www.2gb.com/article/natalie-peters-barbara-masser-national-blood-donor-week#xSfFUWr0R8hCMlzC.99

Barbara Masser Interview on 612 ABC radio during National Blood Donor Week, 14 June 2016 Available at http://blogs.abc.net.au/

queensland/2016/06/celebrating-blood-and-blood-donors-with-professor-barbara-masser.html?site=brisbane&program=612_evenings

Transfusion Update session, August 2016. Predicting the future: donor research to impact policy and procedure:

• Dr Daniel Waller: Donor research to support future policy and practice.

• Associate Prof Barbara Masser: The blood donation experience – motivations and barriers to blood donation.

• Prof Bob Slonim: Application of econometric principles in blood donation.

• Dr Stephen Wright: The future of donor research – big data and bio-behavioural studies.

Donor health and wellbeingWright ST The part time statistician: an applied appointment in a large non-government organisation. Mathematical and Statistical

Seminar Series, University of Technology Sydney. 3 June 2015.

Wright ST Outcome-dependent sampling and clustered binary data. Annual Workshop of Australian Research Council Centre

of Excellence for Mathematical and Statistical Frontiers 5 November 2015

APPENDIX 1


52

Invited external presentations (cont.)

Product development and storageJenkins E, Wood B, Marks DC, Johnson L. The effects of storage conditions on the glycosylation patterns of platelet receptors. Sydney

Medical School Summer Research Scholarship- Deans prize. Centenary Institute, Sydney, NSW, 23 February 2016. *Awarded Deans Prize

for best presentation*

Johnson L (presented by Marks DC). Inter-laboratory comparison of frozen platelet quality. Biomedical Excellence for Safer Transfusion

Collaborative. Long Beach, California, USA 21-22

Loh YS, Lu Z, Zreiqat H, Marks DC. Platelet Lysate: A suitable substitute for foetal bovine serum for propagation of therapeutic human

cells. Biotherapeutics Association of Australia. Brisbane, Australia 23 October, 2015

Marks DC. Survey: Blood collection and processing methods for serum eye drops. Biomedical Excellence for Safer Transfusion

Collaborative. Long Beach, California, USA 21-22 October, 2015

Marks DC and van der Meer, P. Development of guidelines for serum eye drop production. Biomedical Excellence for Safer Transfusion

Collaborative. Oxford, UK, 15-16 April 2016.

Marks DC. Can we extend the shelf-life of cryoprecipitate? Strategic Blood Forum, Sydney, Australia. 25 November 2015

Tan JCG. How research and development supports the Blood Service. University of Sydney Central Clinical School Young Investigator

Seminar 26 April, 2016

Tan, JCG. Blood Groups and Antibodies Prince of Wales Hospital Haematology Oncology Day Clinic Seminar 20 November 2015

L Johnson. Occasional address at Autumn Science Faculty Graduation, UTS, 26 April 2016

L Johnson. Frozen blood products become a practical reality, Festschrift for Narelle Woodland, UTS, 16 June 2016

Product safetyDean MM.Transfusion-associated immune modulation in cardiac surgery:Study overview. The Prince Charles Hospital, 16 February 2016

Faddy HM. Transfusion transmissible pathogens relevant to the region. IPFA Asia Pacific Workshop, 8 March 2016.

Faddy HM. Transfusion risk from emerging pathogens in the Asia Pacific Region. 26th Regional Congress of the International Society

for Blood Transfusion, 16 November 2015.

Faddy HM. Transfusion transmitted infectious diseases in Australia: Current practice and research activities, Hologic, 28 August 2015.

Faddy HM. Flower RLP. Is Dengue an increasing risk in Australia? HSANZ/ANZSBT/ASTH Annual Scientific Meeting, 23 October 2015.

Faddy HM. How do blood services evaluate and manage new infectious threats to blood safety? Transfusion Outcomes Research

Collaborative symposium, 11 September 2015.

Faddy HM. Mosquito-borne threats to Australia; consequences for blood supply safety. Transfusion update: dengue fever update,

11 November, 2015.

Hyland CA. Application of Molecular Techniques in the investigation of blood group systems Advanced Transfusion Science Workshop,

RMIT, Melbourne, Victoria. Friday 4th September, 2015.

Hyland CA. Gene sequencing and the future of genotyping in transfusion medicine Advanced Transfusion Science Workshop, RMIT,

Melbourne, Victoria. Friday 4th September, 2015.

Hyland CA “Transfusion Symposium” -Rh Background Information Saturday; HSANZ/ANZSBT/ASTH Annual Scientific Meeting Adelaide

Convention Centre 17 October, 2015.

Hyland CA 2016 Cell free fetal RHD genotyping Transfusion Update Melbourne Convention Centre, Thursday 2 June 2016

Tung JP. Introduction of animal models in transfusion. Transfusion Update. Brisbane, Australia. 9 September 2015.

Tung JP. TRALI: in sickness and in sheep. Transfusion Update. Brisbane, Australia. 9 September 2015.

APPENDICES

53

Product usageHirani R Does leucodepletion remove long-term transfusion related outcomes in recipients? HAA joint scientific meeting (ANZSBT

presidential symposium), 18 - 20 October 2015

Hirani R O RhD negative blood use Strategic Blood Forum, 25 November 2015

Hirani R O Rh(D) negative blood usage survey Transfusion Update, 2 - 3 June 2016

Tan JCG Blood Groups and Antibodies Prince of Wales Hospital Haematology Oncology Day Clinic Seminar, 20 November 2015

Tan JCG How Research & Development Supports the Blood Service University of Sydney Central Clinical School Young Investigator

Seminar, 29 April 2016

Books and other materials Donor behaviourRussell-Bennett, R, Smith, G, Chell, K, Goulden, J. Social influence and blood donation: Cultural differences between Scotland

and Australia. In Wymer, W (Ed.) Innovations in social marketing and public health communication: Improving the quality of life

for individuals and communities. Springer International Publishing, Cham, Switzerland, 133-158.

Product development and storageBen Wood Honours Thesis, 2015. Using proteomics to understand the mechanisms mediating the haemostatic function of cold-stored

platelets. The University of Technology, Sydney. *Awarded first class honours*

Product safetyGould A, Faddy H. Disease in the dust GrassROOTS. Summer 2015/16 edition, .

Gould A, Faddy H Disease in the dust Life donor magazine. Summer 2015/16. .

Faddy H, Seed C. Blood safety and the Ross River virus. Transfusion Today. Number 105, 2015,

Yu Ji, Masters of Science Thesis, 2016. Genetic Factors Associated with Blood Donation Career: Iron Metabolism and Storage.

The University of Queensland.

Anna Coghlan MBBS Honours Thesis, 2015. The benefit of deferring donations from Australian blood donors returned from travelling

abroad. The University of Queensland.

Elise Hewlett Bachelor of Biomedical Science Honours Thesis, 2015. Investigating the prevalence of Ross River and Liao ning viruses

in the Australian blood supply. The University of Queensland.

Katrina Kildey PhD Thesis, 2016. Genetic studies of red blood cell differentiation and stability: ENU-induced murine mutations

Queensland University of Technology.


54

APPENDIX 1International database listings

When a new variant of a gene is discovered it is important that this information is available to inform genetic analysis and establish discovery. In this reporting period, a number of novel variants of blood group genes were discovered by the R&D team and were published in Genbank, the most widely accessed and recognised repository of genetic information. All entries in Genbank are reviewed and curated by independent experts to ensure their novelty and accuracy.

GenBank Accession Numbers GenBank Accession Number KX363592. Shrestha, AC, Flower RLP, Seed CR, Keller AJ, Harley R, Chan HT, Hoad V, Warrilow D, Northill J,

Holmberg JA. and Faddy HM. Hepatitis E virus RNA in Australian blood donations, methyltransferase (ORF1) bases 1 to 295.

GenBank Accession KX363593. Shrestha AC, Flower RLP, Seed CR, Keller AJ, Harley R, Chan H-T, Hoad V, Warrilow D, Northill J,

Holmberg JA and Faddy HM. Hepatitis E virus RNA in Australian blood donations, ORF2/3 bases 1 to 97

Mouse Genome Informatics MGI:5705148. Kildey K, Flower RL, Tran TV, Tunningley R, Harris J, and Dean MM, Ank1, Chromosome 8

location 22974844- 23150497.

GenBank Accession Number KT037686 McBean RS, Hyland C, Liew YW. and Flower RL. Homo sapiens equilibrative nucleoside

transporter 1 variant ata (SLC29A1) gene, partial cds

GenBank Accession Number KP136911 Hyland C, Ochoa G. Homo sapiens Rhesus blood group CE antigen (RHCE) gene,

RHCE*ce202G allele, exon 2 and partial cds

NCBI.NIH Clinical variation data base. rs number 869312818 Schoeman E, Flower R. Single nucleotide variant on Cromer blood group:

Affected gene is CD55 molecule (Cromer blood group) CD55.. www.ncbi.nlm.nih.gov. 21 March 2016

APPENDICES

55

APPENDIX 2Grants Active 2015-16

Donor behaviour$864 100 Behavioural Economics to better understand and increase plasma and bone marrow donations. Australian

Research Council Discovery Project (DP150101307; 2015-19); Chief Investigator: Slonim R.

$392 000 Emotional psychology of blood donors: Understanding and using the affective key to donor return. Australian

Research Council Linkage Project with the Australian Red Cross Blood Service (LP140100034; 2015-17);

Chief Investigators: Williams L, Masser B.

$229 905 Evaluating a model for culturally relevant interventions to increase blood donation and overcome perceived

blood donation barriers among migrant communities. Australian Research Council Linkage Project with the

Australian Red Cross Blood Service (LP120200065; 2013-16) Chief Investigators: Polonsky M, Renzaho A,

Smith G, Jones S.

Product development and storage$10,000 Understanding the mechanisms mediating the haemostatic function of cold-stored platelets. ANZSBT;

Chief Investigators: Johnson L, Marks DC Associate Investigator; Padula M.

$360,000 Biomimetic Blood Bag materials for prolonged platelet storage. Australian Research Council Linkage grant

(LP140101056 2014-2017) Investigators: Whitelock, JM, Lord MS; Farrugia BL; Irving DO

Product safety$450 000 The first integrated multimodal assay for the ultrasensitive detection of dengue contamination of blood.

Australian Research Council Linkage grant; Chief Investigators: Cooper M, Young P, Mahler S; Partner

Investigators: Faddy H, Irving D, Flower R

$382 000 Develop a novel modelling framework to represent the biomechanical properties of red blood cells over time

under stored conditions. Australian Research Council Linkage grant; Chief Investigators; Gu YT, Sauret E,

Saha S, Xiao; Partner Investigators: Flower RLP, Faddy HM.

$10 000 Investigation of transfusion related modulation of dendritic cell function in cardiac surgery patients. The Prince

Charles Hospital Foundation New Investigator Grant: Chief Investigator: Perros A. Mentor: Dean MM

$16 500 Exposure of damage associated molecular patterns during routine blood storage: potential mechanisms

associated with red blood cell clearance and post-transfusion immunomodulation. Australia and New Zealand

Society of Blood Transfusion Research Fund. Chief Investigator: Dean MM. Associate Investigators: Ki KK,

Chong FN, Flower RL.

$599 995.32 Advanced Cardio-respiratory Therapies Improving OrgaN Support (ACTIONS). The Prince Charles Hospital

Foundation Program Grant. Chief Investigators: Fraser JF, Gregory SD, Shekar K, Olive C, Tansley G, Platts

DG, Tung JP, McGiffin DC, Thomson B, Bull T; Associate Investigators: Barnett AG, Bannon P, Marasco S,

Anstey C, Timms D, Brodie D, Moore J, Fanning J, Spooner A, Simmonds MJ, Molenaar P, Robins E; Junior

Investigators: Yuen A, Diab S, Pauls JP. McDonald C, Ng MSY, Simonova G, Sutt AL, Martin H.

$949 279 Understanding tissue responses to fluid resuscitation and blood transfusion during ovine sepsis to improve

outcomes (APP1061382). NHMRC Project Grant. Chief Investigators: Fraser JF, Maitland K, Shekar K, Chew

MS, Reade MC, Fung YL, Tung JP; Associate Investigators: Barnett AG, Nichol A, Sim B, Platts DG, Moore

JP, Turnbridge M, Singer M, Ng MSY, Bellomo R


56

APPENDIX 2Grants Active 2015-16

Product safety (cont.)$200 000 Adding “Insult to Injury” – The effect of fresh and aged blood to oxygenation, metabolism and organ function

in a clinically relevant trauma/sepsis model. Queensland Emergency Medicine Research Foundation

(QEMRF) Project Grant. Staib A, Fraser JF, Fung YL, Shekar K, Chew MS, Reade M, Tung JP, McDonald C,

Collier J, Dunster KD, Diab S, Barnett AG.

$350 000 A new biomechanical model for the understanding of aging of stored red blood cells. (2015-2018)

ARC linkage grant Investigators: Flower RF, Faddy H, Gu YT, Sauret E, S Saha S, Xiao Y

Product usage$470 063 Exploring the impact of blood transfusion on maternity outcomes and healthcare utilisation:informing the

use of blood and blood products in the obstetric setting. NHMRC Chief investigators: Ford J (University

of Sydney), Irving DO, Nicholl M.(NSW Kids and Families)

$2 761 870 STandarRd issue trANsfusion versuS Fresher red blood cell Use in intenSive care (TRANSFUSE) NHMRC

Project Grant (2012-2015) Investigators: Cooper DJ, Nichol AD, French C, Street A, Bellomo R,

Irving D and Mondy P (2012-2015)

New Grant Applications: Successful Product safety$10 000 BioPlatforms Australia. End user access and engagement grant. Chief Investigator: Hirani R.

$470 063 Exploring the impact of blood transfusion on maternity outcomes and healthcare utilisation: informing the

use of blood and blood products in the obstetric setting National Health and Medical Research Council

(NHMRC)/Partnership Projects. (May 2016-June 2020) Chief Investigators: Ford J, Roberts C, Irving D,

Morris J, Nicholl M, Bowen J;

$4 340 802 ARC Training Centre for Biopharmaceutical Innovation. Australian Research Council, Industrial

Transformation Training Centres. Chief Investigators: Mahler S, Alexandrov K, Barnard R, Francois M,

Gray P, Hodson M, Hou J, Howard C, Jones M, Lua L, Osborne G, Schulz B, Young P. Partner Investigators:

Andrews A, Dean MM, Flower RL, Glover D, Irving D, Lee YY, Nisbet I, Nielsen L, O’Meara T, Owczarek C,

Panousis C, Sandford V, Shave E, Tung JP, Wilson M.

$4 996 416 Centres of Research Excellence - Australian Partnership (for) Preparedness Research on InfectiouS

(disease) Emergencies (APPRISE) National Health and Medical Research Council CI team: Professor

Sharon Lewin, Professor Tania Sorrell, Professor Jodie McVernon, Professor Steve Webb,Professor John

Kaldor, Professor Ross Andrews, Professor Allen Cheng, Professor Gwendolyn Gilbert, Professor David

Smith, Professor Soren Alexandersen

APPENDICES

57

APPENDIX 3Abstracts accepted for conference oral or poster presentations

Donor behaviourGemelli CN, Thijsen A, Waller D, Wright ST, Masser BM. Impact of temporary deferrals on time to return: Differences between established

and newly frequent blood donors. The Annual Meeting of the AABB, 22-27 October 2015, California, USA (Poster)

Gemelli CN, Thijsen A, Waller D, Hayman J. Frequent Whole Blood And Apheresis Donors: Understanding Characteristics And Return

Behaviour. ISBT Regional Meeting, 14-16 November 2015, Bali Indonesia (Poster)

Gemelli CN, Williams LA, Thijsen A. Motivations of blood donors: the impact of self-determined motives on donor return. Society

of Australasian Social Psychologists Annual Meeting, 31 March-2nd April 2016, Brisbane Australia (Oral)

Thijsen A, Gemelli CN, Williams LA. Predicting blood donor return using identity and theory of planned behaviour. Society of Australasian

Social Psychologists Annual Meeting, 31 March-2nd April 2016, Brisbane Australia (Oral)

Donor health and wellbeingGemelli CN, Ji Y, Hayman J, Waller D. Haemolysis of red blood cells: Examining demographic and lifestyle impacts. HAA Joint Scientific

Meeting, 18-21 October 2015. Adelaide, Australia (Poster)

Thijsen A, Gemelli CN, Wright ST, Waller D, Masser BM. Factors associated with Blood donation in an older population: A comparison

between donors and Non-donors. AABB Annual Meeting, 22-27 October. California, United States of America (Poster)

Thijsen A, Waller, D, O’Donovan, J, Bell, B. Delayed Vasovagal reactions following Blood Donation. ISBT Regional Conference,

14-16 November 2015. Bali Indonesia (Poster)

Product development and storageLoh YS, Kwok M, and Marks DC. Pathogen inactivation and storage of platelets increases neutrophil-platelet aggregation

and IL-8 secretion. HAA2015, Adelaide, Australia, 18-21 October 2015. (Poster)

Tan S, Marks DC, Johnson L. Does the method used to manufacture plasma affect its haemostatic activity? HAA2015, Adelaide, Australia,

18-21 October 2015. (Poster) *Awarded Young investigator for best abstract

Wood B, Padula M, Marks DC, Johnson L. Cold-induced morphological changes of platelet concentrates may be mediated by alterations

in cytoskeletal proteins. 32nd Combined Health Science Conference, New Horizons, University of Technology, Sydney, Australia. 23-25

November 2015. (Poster) *Won Best Poster presentation*

Tan S, Tatuava T, Picozzi K, Waters N. Knowledge, attitudes and practice of blood donation in Rarotonga, Cook Islands. HAA2015,

Adelaide, Australia, 18-21 October 2015. (oral)

de Korte D, Thibault L, Morrison A, Fitzpatrick A, Marks DC, Seltsam A, J Acker, On behalf of the Biomedical Excellence for Safer

Transfusion (BEST) Collaborative. Timing of gamma irradiation and sex of blood donor influences in vitro characteristics of red cell

concentrates Transfusion. 2015; 55 (issue S3): 3A-255A. (Oral)

Johnson L, Hyland R, Tan S, Marks DC A glucose-containing additive supports in vitro recovery of cryopreserved platelets after thawing.

Transfusion. 2015; 55 (issue S3): 3A-255A (Poster)

Johnson L, Hyland R, Tan S, Tolksdorf F, Sumian C, Seltsam A, Marks DC. Reduced plasma carryover has little effect on the in vitro

quality of platelets treated with ultraviolet C light for pathogen inactivation. Transfusion. 2015; 55 (issue S3): 3A-255A. (Poster)

Winter KM, Hyland R, Tan S, Fisher JE, Bondar N, Orr A, Marks DC. An assessment of apheresis plasma collected by using

the Haemonetics high-separation core. Transfusion. 2015; 55 (issue S3): 3A-255A. (Poster)


58

APPENDIX 3Abstracts accepted for conference oral or poster presentations (cont.)

Product safetyAung HH, Tung JP, Dean MM, Flower RL, Pecheniuk NM. A potential procoagulant role of red blood cell derived microparticles: Risk factor

for adverse outcomes in transfusion. Annual Scientific Meeting of HAA. 18th – 21st October 2015. Adelaide, Australia. (poster)

Boon AC, Narula M, Diab S, Passmore M, Fung YL, Shekar K, Tung JP, Fraser JF. ECMO therapy with blood transfusion attenuates

myocardial inflammation and injury in an ovine model of S-ALI. The Prince Charles Hospital Annual Health Discoveries Forum.

5th – 6th November 2015. Brisbane, Australia. (oral)

Byrne L, Diab S, Passmore M, Dunster K, Boon AC, Fauzi MH, Tung JP, Van Haren F, Obonyo N, Maitland K, Anstey C, Shekar K, Fraser

JF. Septic Shock Does Not Impair Cardiac, Renal or Cerebral Oxidative Metabolism But May Impair Splanchnic Metabolism in an Ovine

Model of Supported Endotoxaemic Shock. Australia and New Zealand Intensive Care Society (ANZICS) / Australian College of Critical Care

Nurses (ACCCN) Intensive Care Annual Scientific Meeting. 29th – 31st October 2015. Auckland, New Zealand. (oral)

Byrne L, Obonyo N, Diab S, Passmore M, Dunster K, Boon AC, Tung JP, Shekar K, Cullen L, Maitland K, Fraser JF. Fluid resuscitation

and blood transfusion result in higher vasopressor requirements in an ovine model of endotoxemic shock. The Prince Charles Hospital

Annual Health Discoveries Forum. 5th – 6th November 2015. Brisbane, Australia. (oral)

Coghlan A, Flower R, Seed C, Herbert D, Hoad V, Harley R, Yang HS, Faddy H. The benefit of deferring donations from Australian blood

donors travelling abroad. HSANZ/ANZSBT/ASTH Annual Scientific Meeting, 18 – 21 October 2015. Adelaide, Australia. (Oral presentation)

Coghlan A, Flower R, Seed C, Herbert D, Hoad V, Harley R, Yang HS, Faddy H. The yield of deferring blood donations from Australian

blood donors returned from travelling abroad. UQ Undergraduate Student Symposium, 15 – 16 September 2015. Brisbane,Australia (Oral).

Colbran R, Dean M, Flower R, Harley R, Faddy H. The Role of the Australian Red Cross Blood Service Donor History Questionnaire in

Detecting Acute Retroviral Syndrome and Maintaining HIV Transfusion Safety. UQ Undergraduate Student Symposium, 15 – 16 September

2015. Brisbane, Australia (Oral).

Dean MM, Dunford M, Flower RL, Faddy HM. Biological markers of infection may assist in the identification of early stage viral infection

and serve as a surrogate biomarker to identify asymptomatic Ross River or Barmah Forest virus infection. American Association

of Immunologists, 2016, May 13 -17, 2016 Seattle, USA. (Poster)

Dean MM, Luimstra J, Rooks K, Flower RL. Investigation of immune cell maintenance and function in MBL-sufficient and MBL-deficient

individuals. American Association of Immunologists, 2016, May 13 -17, 2016 Seattle, USA. (Poster)

Faddy HM. Transfusion transmissible pathogens relevant to the region. IPFA Asia Pacific Workshop, 8 – 9 March 2016. Taipei, Taiwan.

(Invited Presentation).

Faddy HM, Viennet E, Flower R. Transfusion Risk From Emerging Pathogens in the Asia-Pacific Region. Vox Sanguinis, Volume 109

(Suppl. 2), November 2015. The 26th Regional Congress of the International Society of Blood Transfusion, 14 November – 16 2015.

Bali, Indonesia. (Invited presentation).

Faddy HM, Fryk JJ, Seed CR, Hyland C, Holmberg JA, Flower R. The Search for Dengue Virus in Australian Blood Donations During

Local Outbreaks. The 26th Regional Congress of the International Society of Blood Transfusion, 14 November – 16 November 2015.

Bali, Indonesia. (Poster).

Faddy HM, Fryk JJ, Young PR, Watterson D, Hall RA, Prow NA, Hobson-Peters J, Reichenberg S, Marks DC. Inactivation of Dengue

and Chikungunya Viruses With the Theraflex MB-Plasma System. The 26th Regional Congress of the International Society of Blood

Transfusion, 14 November – 16 November 2015. Bali, Indonesia. (Poster).

Faddy HM, Rooks KM, Seed CR, Harley RJ, Chan HT, Keller AJ, Dennington PM, Hoad VC, Stramer SL, Berardi VP, Irwin PJ, Senanayake S,

Flower RLP. Babesia sero-epidemiology in Australian blood donors. International conference of emerging infectious diseases,

24 – 26 August 2015, Atlanta, USA. (Poster presentation).

APPENDICES

59

Product safety (cont)Flower RLP, Shrestha AC, Faddy HM. Hepatitis E virus as an emerging risk to blood safety: An Australian perspective. 8th International

Blood Transfusion Congress, Africa Society for Blood Transfusion (AfSBT), 31 May – 1 June 2016. Kigali Rwanda. (Oral)

R Flower, Liew Y-W, Wilson B, Kupatawintu P, Emthip M, Hyland CA, McBean RS. Molecular genotyping and a potential 36th blood group

system: the rs45458701 variant in the ENT 1 transporter in a patient typing as At(a) negative HSANZ/ANZSBT/ASTH Annual Scientific

Meeting, 18 – 21 October 2015. Adelaide, Australia. (ANZSBT Presidential Symposium)

Flower RL, Schoeman E, Liew Y-W, Condon J, Powley T, Lopez G, Hogan C, Hyland CA Massively Parallel Sequencing in Complex Blood

Group Investigations: Resolving the Previously Unresolvable – International Academy of Pathology Australasian Division 40th Annual

Scientific Meeting: (Poster presentation)

Flower RL, Schoeman EM, McGowan E, Millard G, Lopez G, O’Brien H, Hyland CA African RHD blood group genotypes as a complication

of non-invasive prenatal testing 8th International Congress:Africa Society for Blood Transfusion 31st May to 1st June 2016 Kigali,

Rwanda: (oral presentation)

Hyland CA, Millard G, O’Brien H, McGowan E, Tremellen A, Flower RL, Puddenphatt R, Hyett J, Gardener G. Feasibility of applying non-

invasive fetal RHD genotyping to determine which D-negative pregnant women require anti-natal anti-D immunoglobulin prophylaxis:

HSANZ/ANZSBT/ASTH Annual Scientific Meeting, 18 – 21 October 2015. Adelaide, Australia. (Poster presentation)

Hyland CA, Lopez G, McGowan E, Millard G, Liew YW, Flower RL Non-invasive fetal RHD genotyping for D-negative women harbouring

RHD*D-CE-D gene variants: accuracy in detection of fetal specific RHD signals HSANZ/ANZSBT/ASTH Annual Scientific Meeting,

18 – 21 October 2015. Adelaide, Australia. (Poster presentation)

Hyland CA, Schoeman E, McGrath K, Wilson B, Lin HC, Wu HC, Flower RL, Powley T, Liew LW. Investigation of a Patient With a Pan-

Reactive Red Cell Antibody Inhibited By Soluble Cd 55: MPS Reveals a Homozygous Novel Cromer Blood Group Allele. 26th Regional

Congress of the ISBT Bali, Indonesia (Poster presented by H Faddy)

Ji Y, Faddy H, Hyland C, Waller D, Flower R. Genetic Factors Associated with Ferritin Levels in Australian Blood donors. HSANZ/ANZSBT/

ASTH Annual Scientific Meeting, 18 – 21 October 2015. Adelaide, Australia. (Poster presentation)

Ki KK, Flower RL, Faddy HM, Dean MM. Differential modulation of inflammatory mediator production by dendritic cell subsets in

an in vitro model of red blood cell transfusion. European Congress of Immunology, 6-9 September 2015, Vienna, Austria. (Poster)

Perros AJ, Christensen AM, Flower RL, Dean MM. Transfusion-Related Immune Modulation: Impact of Dose and Ex-vivo Storage of Platelet

Concentrates on Dendritic Cell (DC) Responses. The Prince Charles Hospital Annual Health Discoveries Forum. 5th November 2015. (Oral)

Perros AJ, Christensen AM, Flower RL, Dean MM. The Interaction Of Leucocyte Subsets Is Critical For The Assessment Of Mechanisms

Associated With Transfusion-Related Immunomodulation. Australian and New Zealand Society of Blood Transfusion Combined Scientific

Meeting, Adelaide Australia; October 2015. (Poster)

Prow NA, McLean B, Colmant AMG, Deerain J, O’Brien C, Harrison JJ, Piyasena TBH, Warrilow D, Webb CE, Hobson-Peters J, Faddy

HM, Suhrbier A, Bielefeldt-Ohmann H, Hall RA. Assessing the risk of a newly emerged reovirus, Liao Ning virus to the Australian

population. 8th Australasian Virology Society (AVS) Meeting, 6-9 December 2015, Hunter Valley, Australia (Poster).

Rooks K, Chong FN, Tung JP, Flower RL, Dean MM. An interim analysis: do donor and/or processing associated parameters contribute

to biological variation in biological response modifiers (BRMs) in packed red blood cells? Australian and New Zealand Society of Blood

Transfusion Combined Scientific Meeting, Adelaide Australia; October 2015.(Poster)

Shrestha AC, Flower RLP, Seed CR, Keller AJ, Hoad V, Harley R, Leader R, Polkinghorne B, Furlong C, Faddy HM. Hepatitis E Virus

Infections in Travellers: A Threat in Australia? The 26th Regional Congress of the International Society of Blood Transfusion, 14 November

– 16 November 2015. Bali, Indonesia. (Poster).

Shrestha AC, Flower RLP, Seed CR, Keller AJ, Harley R, Chan HT, Hoad V, Warrilow D, Holmberg JA, Faddy HM. Detection of Hepatitis E

Virus in Australian Blood Donations. The 26th Regional Congress of the International Society of Blood Transfusion, 14 November

– 16 November 2015. Bali, Indonesia. (Poster).

Wei L, Ju Y. Luo G, Hyland CA, Flower R. Hybrid glycophorins: silent genetic variants complicate genetic testing:– International Academy

of Pathology Australasian Division 40th Annual Scientific Meeting: (Poster presentation)


60

APPENDIX 3Abstracts accepted for conference oral or poster presentations (cont.)

Product usageHirani R. Does leucocyte filtration really remove long-term transfusion related outcomes in recipients? HAA Joint Scientific Meeting,

18 – 20 October 2015 (Oral)

Tan JCG, Yuan FF, Daley, J, Marks K, Flower RL, Dyer WB. Homozygosity for the HLA-DRB1*15 allele is associated with a Responder

profile in RhD-immunised blood donors. International Congress of Immunology. 21-26 August 2016. Melbourne, Australia. (Poster)

Dyer W, Tan J, Dean M, Irving D. Immunopathogenic pathways of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and

markers of clinical efficacy of immunoglobulin (IVIg) treatment. Australian Cytometry Society Annual Scientific Conference, 11-14 October

2015, Perth, WA. (poster)

APPENDICES

61

APPENDIX 4Student projects

R&D team members collaborate with universities, research institutes and hospitals to support students undertaking original research under the supervision of senior Blood Service Researchers. A full listing of students and their project titles appears on the following pages. Blood Service supervisors are shown in bold.

Student name Supervisors Project title Institution Degree

Amelie Babinet (current) Natalie Pecheniuk, Marie-

Anne Balanant, John-Paul

Tung, Robert Flower

Red cell storage duration and

procoagulant effects: Role of

microparticles and smaller particles.

ONIRIS (College

of Food and

Health science

and Technology

Engineering), France

Masters in

Biotechnology of

Health, Final year

student placement

Marie Anne Balanant YuanTong Gu, Robert

Flower, Emilie Sauret and

Suvash Saha

Experimental study of the aging

effects on the Red Blood Cell

membrane during storage

QUT PhD

Sarah Barns Yuan Tong Gu, Emilie

Sauret, Robert Flower,

Suvash Saha

Numerical Modelling of Red

Blood Cell Morphological and

Deformability Changes during

the Cell Aging Process in Storage

QUT PhD

Liam Byrne (current) Frank van Haren, John-

Paul Tung, John Fraser

Fluid resuscitation during sepsis:

Effects upon the microcirculation

ANU PhD

Kathleen Chell Rebekah Russell-Bennett,

Gary Mortimer, Geoff

Smith, Tanya Davison

The impact of private and public

online donor appreciation on

charitable behaviour

QUT PhD

Sophie Chen Tan, JCG, Marks, DC Assessment of serum growth factor

inter-donor variability and the

impact on human corneal epithelial

cell proliferation and migration

University of Sydney 2015-16 Summer

Research

Scholarship

Anne-Marie Christensen

(current)

Melinda Dean, John-Paul

Tung, Damien Harkin,

Robert Flower

Extracellular traps and TRALI:

more than just neutrophils

QUT PhD

Anna Coghlan

(completed)

Helen Faddy, Robert Flower The effect of temporary exclusion of

blood donors exposed to emerging

infections while travelling

UQ MBBS Honours

Rachel Colbran (current) Helen Faddy, Melinda Dean,

Robert Flower, Robert

Harley

Is the current blood donor

questionnaire effective in screening

for donor HIV seroconversion?

UQ MBBS Honours

Elise Gorman (current) Helen Faddy, Francesca

Frentiu, Robert Flower

Is Parvovirus B19 a concern

for blood safety in Australia

QUT Bachelor of

Biomedical Science

Honours


62

APPENDIX 4Student projects (cont.)


Elise Hewlett

(completed)

Roy Hall, Natalie Prow,

Helen Faddy

Isolation of RRV and LNV from

human blood donor samples

to assess possible risk blood

transfusion recipients

UQ Bachelor of

Biomedical Science

Honours

Emily Jenkins Lacey Johnson The effects of storage conditions

on the glycosylation patterns

of platelet receptors.

University of Sydney 2015-16 Summer

Research

Scholarship

Yu Ji (completed) Helen Faddy, Catherine

Hyland, Robert Flower

Genetic Factors Associated with

Donation Career: Iron Metabolism

and Storage

UQ Masters

Sunnya Khawaja

(completed)

Helen Faddy, Robert Flower Assisting with research into the

risk to Australia’s blood supply

of emerging infectious diseases.

QUT Bachelor of Public

Health, Final year

student placement

Katrina Ki (current) Melinda Dean, Helen Faddy,

Robert Flower

The role of Clec9A in transfusion

related immune modulation

UQ PhD

Katrina Kildey

(completed)

Melinda Dean, Robert

Flower, Jonathan Harris

Investigation of blood physiology

and hematological disease through

analysis of mice with novel ENU-

induced phenotypes

QUT PhD

Christine Knauth Catherine Hyland

Robert Flower

RhD alloimmunisation:

Risk mitigation

QUT PhD

Assia Moussa Christine Knauth, Elizna

Schoeman, Robert Flower,

Catherine Hyland, Terry

Walsh

The frequency and clinical

significance of In(Lu) variants

QUT Honours

Oliver McGrath

(completed)

Helen Faddy, Ashish

Shrestha, Robert Flower,

Anne-Marie Christensen

Investigation of hepatitis E virus

infection in a cohort of patients

with acute hepatitis

QUT Bachelor of

Science, Vacation

Research

Experience Scholar

Elissa Milford (current) Michael Reade,

John-Paul Tung

Effects of commonly used and

emerging resuscitation fluids on end

organ function in severe trauma

UQ PhD

Monica Ng (current) John Fraser,

John-Paul Tung

The double whammy: impact of

activated endothelium and stored

blood transfusion on microparticle

formation and thrombosis.

UQ PhD

Alexis Perros (current) Melinda Dean, Helen Faddy,

Robert Flower, Stuart Kellie

Investigation of transfusion-related

modulation of dendritic cell function

in cardiac surgery patients

UQ PhD

APPENDICES

63


Kyle Raubenheimer Oliver Neubauer, Natalie

Pecheniuk, John-Paul Tung

The Acute Effects of Nitrate-Rich

Beetroot Juice on Vascular Health

and Haemostatics in the Elderly

QUT (IHBI) Honours

Beatrice Sim (current) John Fraser,

John-Paul Tung

Blood transfusion and risk of sepsis UQ MPhil

Gabriela Simonova

(current)

John-Paul Tung, Melinda

Dean, Michael Reade

Developing laboratory models to

help translate findings from the

sheep model to the clinical setting

UQ PhD

Annette Sultana

(current)

John-Paul Tung Investigation of different

mechanisms that contribute to the

development of transfusion-related

acute lung injury (TRALI)

UQ PhD

Tayla Tatzenko (current) Helen Faddy, Melinda Dean,

Robert Flower

Occult hepatitis C infection: Is

there a risk to transfusion safety?

UQ MBBS Honours

Shaba Vakalia Robert Flower, Louise

Hafner, Rena Hirani, David

Roxby and David Irving

Evaluating the benefits of extended

blood group genotyping in

chronically transfused patients

QUT PhD

Lauren Waters Lacey Johnson, Matthew

Padula (UTS)

Characterisation of the ability of

platelets to respond to activation

signals following cryopreservation

UTS Bachelor of

Biomedical Science

(Honours)

Peter Watson-Brown

(current)

Helen Faddy, Robert Flower Assessing the risk of zika virus

transmission in Australia

UQ MBBS Honours

Ben Wood Lacey Johnson, Matthew

Padula (UTS)

Using proteomics to understand

the mechanisms mediating the

haemostatic function of cold-stored

platelets.

UTS Master of Science

(Honours)


64

APPENDIX 5Collaborations

Government Health Departments and AgenciesInstitution Research area and project Collaborator(s)

Clinical Excellence Commission, NSW Product usage: Exploring the impact of blood transfusion

on maternity outcomes and healthcare utilisation:

informing the use of blood and blood products in

the obstetric setting

Dr Amanda Thomson

Hunter New England Health Product safety: Q Fever: how common is it, who

is at risk and what does this mean for blood safety?

Prod David Durrheim

NSW Health Protection Product safety: Does hepatitis E virus pose a risk

to the Australian blood supply?

Catriona Furlong

National Centre for Immunisation

research and surveillance

Product safety: Q Fever: how common is it, who


Dr NIck Wood, Dr Helen Quinn,

Prof Peter McIntyre

NSW Office of Kids and Families Product usage: Exploring the impact of blood transfusion




Associate Professor Michael Nicholl

Pathwest Laboratory medicine Product safety: Detection of Ross River virus in Australian

blood donations

Dr David Smith, Dr Glenys Chidlow



Dr Linda Hueston

Queensland Health Product safety: Q fever: how common is it, who


Dr Penny Hutchison

Product safety: Detection of Ross River virus in Australian

blood donations

Dr Alyssa Pyke

Dr Sonja Hall-Mendelin

OzFoodNet Product safety: Does hepatitis E virus pose a risk


Dr Robyn Leader, Dr Ben

Polkinghorne

SA pathology Product safety: Red cell alloimmunisation: How can

extended genotyping support the ongoing transfusion

needs of haemoglobinopathy patients?

A/Prof David Roxby

HospitalsInstitution Research area and project Collaborator(s)

The Alfred Hospital Product usage:Validation of candidate immune

biomarkers as predictors of IVIg response in CIDP patients

to promote cost-effective IVIg dosing.

Dr Elspeth Hutton

Prince Charles Hospital Product safety: Reducing the risk of TRALI and Reducing

the risks associated with transfusion

Prof John Fraser and the Prince

Charles Hospital Critical Care

Research Group

APPENDICES

65

Hospitals (cont.)Institution Research area and project Collaborator(s)

Prince Charles Hospital Product safety: Transfusion associated immunomodulation

in a cohort of cardiac patients – translating laboratory

findings to a clinical context

Dr Rishendran Naidoo and Prof

John Fraser

Canberra Hospital Product safety: Investigating levels of BRMs in donors

implicated in clinical cases of TRALI

Prof Matthew Cook, Dr Zuopeng Wu

Concord Repatriation and General

Hospital

Product usage:Validation of candidate immune

biomarkers as predictors of IVIg response in CIDP

patients to promote cost-effective IVIg dosing.

Dr Con Yiannikas

Product usage: Blood product safety in massive

transfusion recipients - Does white cell filtration really

remove transfusion risk?

Prof Peter Maitz , Dr Rosalba Cross

Gosford Hospital Product usage: Blood product safety in massive



Dr Duncan Reed

John Hunter Hospital Product usage: Blood product safety in massive



Prof Zsolt Balogh

Mater Mothers’ Hospital Brisbane Product safety: Reduction in anti-D immunoglobulin

usage by genotyping: a cost (and) benefit analysis

Dr Glen Gardener

Orange Health Service Product usage: Blood product safety in massive



Dr Doug Lenton, A/Prof Brian Burns

Royal Adelaide Hospital Product usage:Validation of candidate immune



Dr Pravin Hissaria and Dr Janakan

Ravindran

Royal Melbourne Hospital Product usage:Validation of candidate immune



A/Prof Timothy Day, Prof Lynettte

Kiers

Royal Prince Alfred Hospital Product safety: Reduction in anti-D immunoglobulin

usage by genotyping: a cost (and) benefit

analysis

Clin Prof Jon Hyett

Product Safety: Non-invasive assessment (NIPA)

translation: for high risk pregnant women who are

allo-immunised to the RhD blood group antigen

Clin Prof Jon Hyett

Product development and storage: Development

and characterisation of platelet lysate

Dr Janet McPherson and

Dr James Favaloro

Product usage:Validation of candidate immune



Prof Matthew Kiernan

St George Hospital Product usage: Blood product safety in massive



Dr Mary Langcake


66

APPENDIX 5Collaborations (cont.)

Hospitals (cont.)Institution Research area and project Collaborator(s)

Sydney Eye Hospital Product development and storage: Development


Simon Cooper

Westmead Hospital Product usage:Validation of candidate immune



Prof Steve Vucic


transfusion recipients - Does white cell filtration

really remove transfusion risk?

Dr Jeremy Hsu, Dr Leonardo Pasalic

Royal North Shore Hospital Product usage:Validation of candidate immune



Dr Karl Ng


transfusion recipients - Does white cell filtration

really remove transfusion risk?

Dr Tony Joseph, Dr Mark Gillett,

Dr Lesley Survela

Product safety: Red cell alloimmunisation: How can



Prof Chris Ward

Product usage: Exploring the impact of blood transfusion




Prof James Isbister, Dr Jennifer

Bowen, Dr Eleni Mayson

IndustryInstitution Research area and project Collaborator(s)

Australian Defence Force Product usage: Clip Trial - Cryopreserved versus Liquid

Stored Platelets for surgical bleeding

Prof Michael Reade

Blood Systems Research Institute Product safety: Exotic mosquito-borne virus threats

to Australia (including WNV, CHIKV, LNV etc.):disease

burden and consequences for blood supply safety

Prof Eric Delwart

CSL Product usage:Validation of candidate immune



Dr Souravi GHosh, Dr Adrian

Zuercher and Dr Bradley Sedgmen

Grifols Product safety: Does hepatitis E virus pose a risk


Dr Jerry Holmberg

Macopharma Product usage: A Phase III prospective, randomised,

double-blinded multicentre clinical trial on clinical

efficacy and safety of platelet concentrates treated with

the Theraflex UV-Platelets system in comparison to

conventional platelet components

APPENDICES

67

Industry (cont.)Institution Research area and project Collaborator(s)

New Health Sciences Inc Product development and storage:

Anaerobic Red Cell storage

Dr Tatsuro Yoshida

InternationalInstitution Research area and project Collaborator(s)

American Red Cross Product safety: Does hepatitis E virus pose

a risk to the Australian blood supply?

Dr Susan Stramer

Sanquin Donor health and wellbeing: Development

of an Australian statistical model to predict

haemoglobin deferrals

Dr Mireille Baart

McMaster University, Canada Product usage: A Phase III prospective, randomised,

double-blinded multicentre clinical trial on clinical

efficacy and safety of platelet concentrates treated with

the Theraflex UV-Platelets system in comparison to

conventional platelet components

Nancy Heddle

Dartmouth Hitchcock USA Product development and storage: Use of additive

solutions for reconstitution of cryopreserved platelets

Dr Larry Dumont

Netherlands Military Blood Bank Product development and storage: Use of additive


Dr Femke Noorman

Singapore Defence Medical &

Environmental Research Institute

Product development and storage: Use of additive


Dr Jia Lu

Scottish Blood Transfusion Service Product development and storage: Use of additive solutions

for reconstitution of cryopreserved platelets

Dr Juraj Petrik

New Zealand Blood Service Product development and storage: Use of additive


Dr Darryl Crimmins

Environmental Protection Authority,

New Zealand

Product safety: What is the risk of alloimmunisation by

transfusion of variant RhD red blood cells that serotype

as RhD Negative?

Dr Stacy Scott

Alberta Health Service Canada Product safety: What is the risk of alloimmunisation by


as RhD Negative?

Fiji National Blood Service of

the Republic of Fiji Islands Ministry

of Health

Product safety: Building Capacity to solve complex

red cell serology using genetic sequencing

Adriu Sepeti


68

APPENDIX 5Research InstitutesInstitution Research area and project Collaborator(s)

ARC Centre of Excellence for

Mathematical & Statistical Frontiers

(ACEMS)

Donor Health and Wellbeing: 45 and Up: Blood Service

data linkage project: a world-class donor health data-asset

Prof Louise Ryan

Donor Health and Wellbeing: Safety and feasibility

of first appointment plasmapheresis donation

Prof Louise Ryan

Donor Health and wellbeing: Development of an

Australian statistical model to predict haemoglobin

deferrals

Prof Louise Ryan

Australian Genome Research Facility Product safety: Genetic basis for blood groups

The Australian and New Zealand

Intensive Care Research Centre

Product usage: TRANSFUSE - Standard Issue Transfusion

versus fresher red blood cell use in

intensive care - a randomised controlled trial

Prof DJ Cooper

Australian Phenomics Facility Product safety: Modelling genetic risks for poor

red cell storage

Robert Tunningley

Burnet Institute Product usage:Validation of candidate immune



Prof Mark Hogarth

Brain and Mind Research Institute Product usage:Validation of candidate immune



Prof Matthew Kiernan

Burnet Institute Product usage:Validation of candidate immune



Prof Mark Hogarth

The Kolling Institute, University

of Sydney

Product usage: Exploring the impact of blood transfusion




A/Prof Jane Ford, Prof Jonathan

Morris, Ms Jillian Patterson

Mater Medical Research Institute Product Safety: Non-invasive assessment (NIPA)

translation: for high risk pregnant women who are

allo-immunised to the RhD blood group antigen

Dr Glenn Gardener


Reserach and Surveillance

Product safety: Q fever: how common is it, who


Dr Nick Wood, Dr Helen Quinn,

Prof. Peter McIntyre

Sax Institute Donor Health and Wellbeing: 45 and up study: Blood

Service data linkage project: a world-class donor health

data-asset

Centre for Infectious Diseases and

Microbiology Laboratory Services,

Westmead

Product safety: APPRISE partner Prof Lyn Gilbert

Queensland Institute of Medical

Research-Berghofer Medical

research institute


blood donations

Dr Natalie Prow

APPENDICES

69

Research Institutes (cont.)Institution Research area and project Collaborator(s)

Queensland Institute of Medical

Research-Berghofer Medical

research institute

Product safety: Exotic mosquito-borne virus threats



Prof Andreas Suhrbier,

Dr Greg Devine

Product safety: Reduction in anti-D immunoglobulin

usage by genotyping: a cost (and) benefit analysis

Dr Louisa Gordon

Clinical Excellence Commission, NSW Product usage: Exploring the impact of blood transfusion


informing the use of blood and blood products


Dr Amanda Thomson

Hunter New England Health Product safety: Q Fever: how common is it, who


Prod David Durrheim

NSW Health Protection Product safety: Does hepatitis E virus pose a risk


TBA


research and surveillance



Dr NIck Wood, Dr Helen Quinn,

Prof Peter McIntyre

NSW Office of Kids and Families Product usage: Exploring the impact of blood transfusion


informing the use of blood and blood products


Associate Professor Michael Nicholl

Pathwest Laboratory medicine Product safety: Detection of Ross River virus in Australian

blood donations

Dr David Smith, Dr Glenys Chidlow



Dr Linda Hueston

Queensland Health Product safety: Q fever: how common is it, who


Dr Penny Hutchison


blood donations

Dr Alyssa Pyke

Dr Sonja Hall-Mendelin

OzFoodNet Product safety: Does hepatitis E virus pose

a risk to the Australian blood supply?

Dr Robyn Leader, Dr Ben

Polonghorne

SA pathology Product safety: Red cell alloimmunisation: How can



A/Prof David Roxby


70

APPENDIX 5UniversitiesInstitution Research area and project Collaborator(s)

Australian National University Product safety: Cellular processes that regulate

the lifespan of red blood cells

Prof Simon Foote, Dr Brendan

McMorran, Dr Gaétan Burgio

Deakin University Donor Behaviour: Evaluating a model for culturally

relevant interventions to increase blood donation and

overcome perceived blood donation barriers among

migrant communities

Prof Michael Polonsky, Prof Andre

Renzaho, Prof Sandra Jones

James Cook University Product safety: Exotic mosquito-borne virus threats



Prof. John McBride

Monash University Product usage: Transfusion Outcomes Research

Collabrative (TORC)

Prof J Mc Neill and members of the

TORC Steering committee

Queensland University of Technology Product safety: Red cell alloimmunisation: How can



Prof Louise Hafner

Product safety: reducing the risk of TRALI Prof Adrian Barnett, Anne-Marie

Christensen

Donor behaviour: Hospitals to Hospitality: Understanding

the influence of Interaction with staff and service quality

on donor intention to donate

Prof Rebekah Russell-Bennett

Product safety: Points of structural failure that may

lead to storage-related changes of red cells

Prof YT Gu, Dr E Sauret, Dr S Saha

and Prof Y Xiao, Sarah Barns

Product safety: What is the risk of alloimmunisation by


as RhD Negative?

Christine Knauth

Product safety: Is parvovirus B19 a concern

for the blood safety in Australia?

Dr Francesca Frentiu

Fiji National Blood Service of

the Republic of Fiji Islands Ministry

of Health

Product safety: Building Capacity to solve complex

red cell serology using genetic sequencing

Adriu Sepeti

University of Newcastle Product safety: Q Fever: how common is it, who


Prof Stephen Graves

University of NSW Product safety: Q Fever: how common is it, who


Dr Heather Gidding

Donor behaviour: The role of pride in motivating and

maintaining blood donations

Donor behaviour: Emotional Psychology of Blood Donors

Dr Lisa Williams

Product develoment and storage: Biomimetic blood

bag materials for prolonged platelet storage

Prof John Whitelock, Dr Megan Lord,

Dr Brooke Farrugia

University of Queensland Product safety: Reducing the risk of TRALI Prof Michael Reade

Donor Behaviour: multiple projects A/Prof Barbara Masser

(co-appointment)

APPENDICES

71

Universities (cont.)Institution Research area and project Collaborator(s)

Product safety: Detection of Ross River virus

in Australian blood donations

Prof Roy Hall

Product safety: Exotic mosquito-borne virus threats



Prof. John Aaskov, Prof. Roy Hall

(UQ), Dr Helle Bielefeldt-Ohman,

Dr John Wright, Dr Jasimme Uddin

Donor behaviour: Hospitals to Hospitality: Understanding

the influence of Interaction with staff and service quality

on donor intention to donate

Dr Jospephine Peevite

Product safety: The first integrated multimodal

assay for the ultrasensitive detection of dengue

contamination of blood

A/Prof Stephen Mahler, Prof

Matthew Cooper, Prof Paul Young

University of South Australia Product safety: Chikungunya and/or Zika virus emergence

and establishment in Australia

A/Prof Craig Williams

University of Sydney Donor Behaviour: Behavioural economics

to understand blood donations

Evarn Ooi co-appointment with

Prof Robert Slonim

Centre for Values, Ethics and the Law in Medicine:

APPRISE partner

Prof Angus Dawson

Product development and storage: Development


Dr Zufu Lu

University of Technology Sydney Donor health and wellbeing: biostatistics, several projects Louise Ryan

Dr Stephen Wright (co-appointment)

Product development and storage:

Characterisation of cryopreserved platelets

Dr Matthew Padula

Product development and storage:

Cold storage of platelets

Dr Matthew Padula

Photo credits

p 4 Dr Alison Gouldp 16, 18 Genghis Lopez

Acknowledgement

Australian governments fund the Blood Service to provide blood, blood products and services to the Australian community.

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