Rd annual report by redcrossblood6

RESEARCH AND DEVELOPMENT

ANNUAL REPORT 2016â&#x20AC;&#x201C;2017

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDICES Appendix 1 - Peer reviewed publications 46 - Peer reviewed published abstracts 50 - Invited publications 53 - Invited external presentations 53 - Public dissemination 55 56 - Books and other materials (including theses) - International database listings 57 Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59 Appendix 3 - Abstracts accepted for oral or poster presentations 60 Appendix 4 - Student projects 66 Appendix 5 - Collaborations 70

Research equips us to face the future with excitement and confidence

Beyond 2020: Connected collaborative and curious CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

FOREWORD Research and Development (R&D) at the Blood Service contributes to outcomes across the business, from donor recruitment to patient safety. This year our team members have contributed their expertise to estimate the risk of Hepatitis E virus in the Australian Blood Supply, collaborated to reduce donor adverse events, and proven the utility of new genetic technology to enable better matching of donors with patients. Our new strategy, Beyond 2020: Connected, collaborative and curious was prepared this year with input from the Executive, Board, Advisory Committee and others. The strategy ensures that our research program continues to respond successfully to new opportunities and changing business needs, effectively translates research outcomes into practice and equips us for future challenges. Building on the strong foundations established over the past several years, we aim to strengthen our performance and broaden the profile of R&D such that we are recognised as leaders in innovative, cutting edge research. The Research and Development Annual Report for 2016-2017 illustrates that we are already making progress on our four key strategic directions as follows:

STRENGTHEN OUR CORE

and have been agile in planning to allow them to assist in a number of short term projects with immediate benefits. These studies, described in more detail in the following pages, range from explorations of how donors perceive our new centre designs, through to assessing the safety and quality of an enhanced method of collecting platelets. R&D has been pivotal in the design and execution of the world’s first clinical trial of first-appointment plasma donation in a non-remunerated environment.

RAISE OUR PROFILE We will promote awareness of our research program within the organisation and in the public arena, through a diverse communications strategy that is tailored to specific audiences while remaining cost-effective.

R&D will be seen as the “go-to” place for Blood Service staff members seeking solutions and for academic and clinical researchers looking for high calibre, outcomes-focused research partners.

In 2016-2017, our researchers presented a record 96 conference presentations, of which 20 were selected to be given orally at major international scientific conferences. These presentations are key to ensuring that our researchers are able to form new innovative collaborations.

This year our researchers have worked with colleagues from across the business to define long term research problems,

We aim to raise our profile in the general public, and this year we have updated our public facing website (www.donateblood.

com.au/research), and taken part in numerous radio interviews and features, and published several successful online science articles for the general public.

been given roles as adjunct Associate Professors, at the University of Sydney and Queensland University of Technology, respectively.

ATTRACT AND RETAIN LEADING EDGE RESEARCHERS

EXTEND OUR REACH

We will be recognised as an employer of choice for bright young researchers in Australia. We will explore the establishment of collaborative, cross-disciplinary networks so we have access to the best available expertise and problem solving skills. We continue to attract high-calibre researchers from around the world to work in our team, and as part of the Centre for Biopharmaceutical Innovation, we have successfully recruited a post-doctoral fellow and four PhD students. Two of the students are supported by highly competitive RTP scholarships (these awards were formerly known as Australian Postgraduate Awards). The number of postgraduate research students who have chosen to carry out their research projects with a Blood Service R&D team member has continued to climb, with a total of 22 PhD students enrolled this year across the team. Two of our Senior Researchers, Dr Denese Marks and Dr Melinda Dean have recently

As the Blood Service ventures into areas beyond blood, such as human breast milk banking, we will explore opportunities to diversify into areas that will leverage our existing skill sets. We have commenced developing a Statistical and Analytics Resource Group (STAR). The vision is to have a thriving unit of analytics professionals and researchers from the Blood Service and tertiary institutions working together with a shared vision to enable data-driven insights for the Blood Sector. We’re developing our collaborative research network and have joined forces with leading cell biologists and clinicians. We’re already seeing very exciting outcomes from studies that use extracts of expired platelets to manufacture experimental cellular therapies for use in regenerative medicine, tissue repair and cancer. This Annual Report highlights our achievements for 2016-2017, including the translation of our research outcomes

to the business and our growing scientific impact on health and medical research sector, while looking towards a collaborative and curious future.

Prof David O Irving Director, Research and Development

MESSAGE

FROM THE CHAIR AND CHIEF EXECUTIVE

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

We’re delighted to present the Australian Red Cross Blood Service Research and Development Annual Report for 20162017, showcasing the impressive, leading edge work being carried out by our Research and Development team. The Blood Service is a unique organisation delivering one of the world’s safest supplies of life-giving blood and blood products, as well as producing world class research and providing expertise in diagnostic, clinical, transplantation and immunogenetics services. In a rapidly changing global environment, our researchers play a pivotal role in positioning us to face emerging challenges. Their work maintains and improves blood safety, makes the best of every donation, demonstrates significant returns to our funders and uses data analytics to understand a range of significant issues for the sector.

MESSAGE

FROM THE CHIEF MEDICAL OFFICER

Key to the success of our research and development team is their focus on delivering real world outcomes, whether that’s how to get a first time donor through the door, or minimising the risk of adverse health outcomes in patients. Their collaborative spirit shines through in their many interactions within the business and with academics, clinicians and others both in Australia and internationally. Our translation is second to none. It’s fantastic to see that our researchers are recognised globally for their expertise, participating in Expert Working Parties and expert consultations for organisations including the International Society for Blood Transfusion and the World Health Organisation. As we look to the future we will be faced with a tougher external environment; we will be stretched to meet the growing demand for plasma products; we will be seeking to find efficiencies and new ways of working within our supply chain; and we will be growing our services to cater to the Australian healthcare sector. Our research team is an integral part of our future, and their work equips us to face the future with excitement and confidence. Our research work wouldn’t be achievable without the confidence and financial investments of our funders – for this we

thank them. We are extremely proud of the calibre of our Research and Development team, which is showcased in this report. We thank them for their outstanding work and continued ability to deliver world-leading research that broadens our contribution to healthcare, and ultimately improve the lives of Australians. Together, we commend our Annual Research Report to you.

James Birch AM, Chair

Shelly Park, CEO

This year has been incredibly productive for Research and Development at the Blood Service. Our researchers continue to work at the top of their fields, collaborating with the research community to deliver realworld outcomes that improve the lives of donors, patients and their families.

questions that relate directly to the provision of health services throughout Australia. Through these relationships we’re able to disseminate our findings to key decision makers in the field, which facilitates translation of our research into tangible benefits for Australians.

The Research and Development team makes a valuable contribution by providing a strong evidence base for decisionmaking within the business, for our clinical colleagues working in hospitals and pathology services across Australia, for Australian governments and for blood operators across the world.

Our reach extends around the globe, through our participation in the Alliance of Blood Operators, where our medical, research and business directors can formulate questions, collaborate broadly and share solutions with colleagues in a global context.

Three years ago the Research and Development team became part of the larger Clinical Services and Research division. This change wove research into the fabric of our everyday work here at the Blood Service and improved our links with clinicians, both within the organisation and in the wider clinical community. Through this we have created efficient channels for the translation of research into practice within the business and across the broader blood and health sectors. My dual role of Chief Medical Officer and Executive Director, Clinical Services and Research, places me at the nexus of business management, clinical transfusion practice and the formulation of health policy. This position provides a clinical lens through which to view our research directions and outcomes. I see the strength of our research program lying in our constructive dialogue with the local medical community, as well as with government health jurisdictions at state, territory and federal levels. These conversations shape our research program to ensure we address

Our new Research and Development strategy, Beyond 2020: Connected, Collaborative and Curious, has been developed to guide our research into the future. I look forward to our innovative solutions which will benefit the donors and patients of Australia and provide unique scientific insights to share with the global transfusion community.

Dr Joanne Pink Chief Medical Officer/Executive Director, Clinical Services and Research

WORKING TOGETHER TO IMPROVE, BUILD AND GROW

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

By partnering with our colleagues within and outside the business, the Research and Development team supports the Blood Service’s strategic directions of IMPROVE

creating an efficient and effective business

securing Australian plasma

Conducting translatable research is just the first step on the road to research translation. Efficient translation of our research outputs into benefits for the organisation or the sector requires cooperation with the end user throughout the research project cycle, from experimental design to technology transfer. Our R&D team have strong relationships with operational divisions and external stakeholders, and are able to respond to requests for research assistance, as well as carrying out longer term strategic research on jointly defined research problems. The outcomes from completed projects this year are shown on page 8, and this section describes how the ongoing research program contributes to the overall strategy of the organisation.

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59 Appendix 3 - Abstracts accepted for oral or poster presentations 60 Appendix 4 - Student projects 66 Appendix 5 - Collaborations 70

BUILD

GROW

making a greater contribution to healthcare

IMPROVE: EFFICIENT AND EFFECTIVE BUSINESS Service excellence for our donors includes helping them feel great after every donation. Our Donor Research team has worked closely with Donor Services to find ways to implement processes to decrease adverse reactions during donations. Designed with the end in mind, staff feedback has been an integral part of the study. A large scale implementation study is being rolled out as a result of this research. Productive and efficient collections and processing are supported by our Product Development and Storage team, who this year have assisted manufacturing with the evaluation of the quality and safety of triple platelet collections in platelet additive

solution. When implemented, this process will increase the efficiency of platelet collection, while maintaining donor and patient safety. Recent studies investigating the coldstorage of platelets support a possible extension of shelf life for this short-lived component. After initial positive results, several extensions to this project are underway to explore how the cold-storage of platelets may provide maximum benefit for inventory. If successful, this work will ensure that hospitals in the city or the country can have access to safe and effective platelets at all times. Our Product Safety team consistently and continuously provides us with information to support evidence-based decision-making

around blood safety. This year a study of the prevalence of hepatitis E virus (HEV) in the Australian donor population was completed, showing that we have one of the lowest incidences of HEV in the developed world. The estimated value of savings to the Blood Service as a result of this project is $3 million per annum. Further studies on parvovirus, cytomegalovirus, Zika, chikungunya and dengue viruses provide a strong foundation for the continued safety of the Australian blood supply. Further, this team has shown the feasibility of the use of genetic technologies to solve complex blood group matching problems, and is assisting the red cell reference laboratory to introduce this technology into routine use to improve outcomes for frequently transfused patients.

Through the ADOPT study, also led by R&D, the Blood Service has carried out the world’s first clinical trial of first-appointment apheresis in a non-remunerated environment. This study has tested the feasibility of donors providing a plasma donation on their first visit, and aims to facilitate recruitment of new plasma donors (see case study on page 29).

BUILD: SECURING AUSTRALIAN PLASMA

We’re working with the Gold Coast University Hospital to trial the use of a purified plasma product known as fibrinogen concentrate in place of cryoprecipitate in trauma. If successful, this may lead to both improved patient outcomes and reduce the currently high demand for AB cryoprecipitate.

Our Donor Research team is intensely focused on building plasma donor capacity for the future, through ongoing projects that use behavioural psychology methods and aim to reduce donor lapse, increase donation frequency, and facilitate conversion of whole blood donors to plasmapheresis. An important study involves data linkage of health records of frequent plasma donors through the 45-and-up study, to explore the long-term effects of plasma donation.

GROW: GREATER CONTRIBUTION TO HEALTHCARE Research and Development is actively engaged in advancing the productivity of the sector. Our work on the use of O negative and CMV negative red cell units provides important information to health providers to enable more efficient use of blood products.

A study of the usage of blood in maternity and during the neonatal period is being conducted through an NHMRC funded partnership with the Kolling Institute and NSW Kids and Families. The study

specifically aims to contribute to improved transfusion guidelines by using data linkage studies. New products lines are being developed in the form of platelet lysate and platelet gels (see page 33). These products can be manufactured from expired platelets, and are useful for manufacturing new life-changing stem cell therapies. This work provides a new product line to advance healthcare from material that would otherwise be wasted.

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

MEASURING OUTCOMES The table below shows the key outcomes from projects that were completed this year. Type of learning

Business practice confirmed, change recommended or alternative suggested

Learning applicable to the broader blood sector and internally

Project number and name

Key business outcome

PS16-07 Hepatitis E virus risk management: a study of 75,000 donations

This research has shown that the rate of hepatitis E infection in Australia is much lower than in other developed countries. This has allowed the Blood Service to accurately model the HEV transfusion transmission risk and determine that routine testing for HEV is not justified in Australia.

DH15-01 A trial of interventions to increase adherence to applied muscle tension during whole blood donation

Our Donor Research team found that donors are most likely to use applied muscle tension and pre-donation water loading to avoid adverse events when they are provided with an instruction card combined with support from staff in centre. They tested a range of materials, including online instructions and a video. In the study, 99 per cent of people who were given the card used the technique. These findings have been implemented in a large scale trial that commenced in 2016-2017.

DB15-02 Recruitment of male donors

This study identified that the influence of family and friends is a key motivator for men under 40 to donate blood. This information and the detailed results of the study have been disseminated to marketing and are being used to inform future campaigns.

DB16-04 Hospitals to hospitality: understanding the influence of interaction with staff and service quality on donor intention to donate

This collaborative study found gender differences in motivations for blood donation, and identified subtypes of masculine identities that are associated with blood donation. These findings could be used to improve electronic word-of-mouth communication. The study used online surveys, analyses of social media content and interviews with donors and non-donors,

DB16-02 Informing new donors about different donation types

This research found that using the welcome pack to inform new donors about different donation types had no significant effect on their rate of return within six or nine months. Thus including such information is not detrimental, and it may improve the success of plasma conversion campaigns.

PS14-16 Reduction in anti-D immunoglobulin usage by genotyping: a cost benefit analysis

This study demonstrated that if non-invasive fetal genotyping for Rh(D) negative pregnancies were introduced, it would be cost neutral to the health system as a whole. The cost of the test would be offset by the cost-saving from the reduction in anti-D usage when a woman is found to be carrying an RhD negative fetus.

PS14-22 Cellular Processes that regulate the lifespan of red blood cells

Our researchers discovered previously unknown molecules in red cells that are important for their metabolism. These molecules are potential targets for new therapeutics. Further development of this concept will take place through a new project at the Centre for Biopharmaceutical Innovation.

UNDERSTANDING THE RATE OF INFECTION OF HEV IN AUSTRALIA HAS LED TO POTENTIAL SAVINGS OF $3 MILLION PER ANNUM Our research has shown that the rate of Hepatitis E infection in Australia is much lower than in other developed countries. This has allowed the Blood Service to accurately model the HEV transfusion transmission risk and determine that routine testing for HEV is not justified in Australia. This information allowed us to avoid introducing costly testing, as has been done in countries such as the UK and Netherlands, saving Australia an estimated $3 million each year.

NEW TECHNOLOGY SOLVES BLOOD TYPING PROBLEMS Our Product Safety team has established technology to determine blood types through genetic analysis. This allows us to determine the details of all 35 blood group systems in a single analysis. Already this technology has allowed our team to solve 29 problem serology cases that were unable to be solved by conventional methods. The technology has now been approved for routine implementation in our Red Cell Reference Laboratories after a formal technology transfer process.

SUPPORT TO KEEP DONORS FEELING GREAT Our Donor Research team wanted to help donors avoid adverse events during their donation, such as fainting and dizziness. They found that donors are most likely to use helpful techniques such as applied muscle tension and pre-donation water loading when they are provided with an instruction card combined with support from staff in centre. Online or video instructions were less effective. These findings have been implemented in a large scale trial commencing in 2016-2017.

IMPROVING EFFICIENCY AND SAFETY OF PLATELET COLLECTIONS Our Product Development and Storage Team collaborated with Donor Services and Manufacturing in a successful evaluation of the quality and safety of triple platelet collections in platelet additive solution (PAS). Triple dose apheresis platelets will enable the Blood Service to increase the productivity of platelet collections. Reducing the volume of plasma in apheresis platelets (from the current 100 per cent to around 40 per cent) and replacing it with PAS will increase patient safety by further reducing the risk of TRALI and allergic transfusion reactions.

TRACKING OUR IMPACT PUBLICATION QUALITY METRICS

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017

The global scientific impact of Blood Service research is growing, reflected in an increase in individual investigator metrics, and in rising measures of the scientific impact of our body of published work. A researcher’s individual impact on their field can be measured in a number of ways. One frequently used measure is the H index, which combines both quantity and citation impact of a researcher’s body of work. The average H-index for our researchers in 2016-2017 is 13.7, up from 11.36 in the preceding year. For comparison, it’s been suggested that for physicists, an H index of 12 is typical for promotion to tenured Associate Professor.

Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

It should be noted that the H-index is a record of a researcher’s lifetime publication achievement, and depending on their career path it may not always reflect the impact of the research that they have conducted at the Blood Service.

APPENDICES

To examine more specifically the impact of Blood Service research over time, this year we have used a new tool to analyse our research output. The tool, known as “iCite”, was developed by the US National Institutes of Health (NIH) Office of Portfolio Analysis and was first made available in late 2016. iCite shows the total scientific influence of a group articles relative to the average NIH funded paper.

Appendix 1 - Peer reviewed publications 46 - Peer reviewed published abstracts 50 - Invited publications 53 - Invited external presentations 53 - Public dissemination 55 56 - Books and other materials (including theses) - International database listings 57 Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59 Appendix 3 - Abstracts accepted for oral or poster presentations 60 Appendix 4 - Student projects 66 Appendix 5 - Collaborations 70

A graph showing the growing impact of publications from Blood Service R&D is shown in Figure 1. By this measure, the impact of our research has increased significantly over the last five years. Note that papers published recently have not yet had a chance to be widely read and cited, so the impact of 2016 papers is expected to grow over time. iCite also provides data on the citation rates of individual publications relative to NIH funded papers. Of particular note, five Blood Service publications relating to the refrigeration or cryopreservation of platelets have citation rates equivalent to the top 20 per cent of all NIH funded publications. Publications relating to donor psychology, transfusion transmitted Ross River virus, cytomegalovirus, age of blood in TRALI and blood usage during pregnancy and birth also appear in this top 20 per cent.

Our published research has a growing impact beyond the confines of the Blood Service, contributing to the growth in global knowledge and practice in blood science. A full list of our publications for 2016-2017 appears in Appendix 1.

FIG 1: GROWING PUBLICATION IMPACT This figure shows the increase in relative citation rate for the set of publications produced by Blood Service R&D, calculated using iCite (http://journals.plos.org/plosbiology/ article?id=10.1371/journal.pbio.1002541). The relative citation rate is the number of citations for each paper published, corrected for citation practices in the discipline, and summed over the portfolio. The horizontal axis shows the year of publication, not the year of citation. The number of citations for recent publications will grow over the following years.

COLLABORATIONS Collaborations with researchers from other institutions at home and abroad provide us with access to additional multi-disciplinary expertise. Of the 53 peer reviewed publications appearing in print during 20162017, 86 per cent were co-authored with researchers from outside the Blood Service, including 28 per cent published with international colleagues. For the second consecutive year, this exceeds the five year target of 25 per cent of publications being overseas collaborations. Our collaborators are listed in Appendix 5. This year saw the opening of the Australian Research Council funded Centre for Biopharmaceutical Innovation, in which the Blood Service partnered with the University of Queensland and industry partners including Patheon Biologics, GE Healthcare and CSL Ltd to train industryready post-graduates in biopharmaceutical development. The Blood Service has one postdoctoral scientist and four PhD students working in this centre.

TRAINING

FIG 2: GROWING RESEARCH TRAINING This figure shows the increase in PhD enrolments and PhD completions over five years.

For our research impact to continue into the future, we need to ensure that bright, innovative researchers are inspired to conduct research in the blood sector. To this end, our 2014-2019 strategy set out to increase the recruitment of PhD students who are scholarship supported by actively promoting Blood Service research programs within universities. The growth of our training in line with our 2014-2019 strategy is shown in Figure 2. During the 2016-2017 year, 22 PhD students were supervised by Blood Service researchers. 11 of these students are supported by external scholarships. Three of these students completed their PhDs this year.

In addition to PhD candidates, ten students have worked with our team on their honours or masterâ&#x20AC;&#x2122;s research projects throughout the year. Details of all our student enrolments are given in Appendix 4.

CONTENTS

PRESENTATIONS

Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

Increasing our impact depends on disseminating the results of our work not only through peer reviewed publications, but through scientific conferences within and outside the blood sector, and more broadly in the public domain. Presentations at scientific conferences are key for establishing new scientific connections, which form the foundations for innovative collaborations. During 20162017, our researchers presented a record 96 conference presentations, 24 of which were invited. Our presentations are all listed in Appendix 3.

Figure 3 shows the growth in our dissemination to the sector through publications and presentations. Our public profile in the mainstream media has increased this year, with six radio interviews, including a 30 minute special on ABC radioâ&#x20AC;&#x2122;s Health Report. We have contributed to several stories posted by the Australian Academy of Sciences on their website Nova-Science for Curious minds. Both of our stories were among the most viewed of all time on the Nova website, and attracted considerable attention when shared on our own Blood Service social media. Our public visibility has been enhanced with a renewed web presence at www.donateblood.com/research. Each of these successes has led to further opportunities and we anticipate growth in these activities in the following reporting period. A full listing of our public profiling activities this year is given in Appendix 1, under Public dissemination.

FIG 3: INCREASED RESEARCH DISSEMINATION This figure shows the increase in our research dissemination through peer reviewed publications and abstracts accepted at conferences.

EXTERNAL GRANTS Our R&D team is currently involved in a range of collaborative grants, which are detailed in Appendix 2. The total value of our grant funded research (over the lifetimes of the grants) stands at over $14.9 million, with a trend over time towards fewer, larger grants. In addition, successful new grant applications this year total $597,000.

Our research has a growing impact beyond the Blood Service, contributing to the growth in global knowledge and practice in blood science

As our influence spreads further afield, Dr Helen Faddy was invited to represent Australia and the Blood Service at a WHO consultation on ‘Estimating the impact of emerging infections to the blood supply: requirements for risk estimation and decision making support’ which was held in Geneva 14-15 June 2017. This invitation is an indication of Dr Faddy’s global leadership in the field of transfusion transmitted diseases.

RESEARCHERS

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

Leading edge research is championed by world-leading researchers who are driven by curiosity and the desire to contribute to society through improving health outcomes. At the Blood Service, our dedicated research team consists of over 50 employees and many student researchers located in Sydney, Brisbane and Melbourne. They apply diverse expertise in fields including psychology, statistics, haematology and molecular genetics to improve outcomes for the organisation, the sector and, most importantly, for donors and patients.

Our research is organised into areas that align with the supply chain of the Blood Service, namely: •

Donor behaviour

•

Donor health and wellbeing

•

Product development and storage

•

Product safety

•

Product usage.

Our team are actively engaged in Australian and international scientific communities, with many holding adjunct academic appointments at universities where they have ongoing collaborations. This year, Denese Marks was appointed as an Adjunct Associate Professor at the University of Sydney Central Clinical School, and Melinda Dean was appointed as Adjunct Associate Professor in the Faculty of Health, Queensland University of Technology.

A/Prof. Marks continues as Associate Editor for the ISBT Science Series, and was one-off Guest Editor of the Journal of Blood Transfusion, publishing an edition last year in August. To ensure that Australia and the Blood Service maintains research skills into the future, our team trains and mentors students in the field of blood research. With the commencement of the Centre for Biopharmaceutical Innovation, our postgraduate program has grown significantly over the last year.

This year marks the first year of multiple PhD completions from our student program, with three students completing their PhDs.

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59

Ashish Shrestha was awarded a PhD from the University of Queensland. His thesis was titled ‘Evaluating the Risks Posed by Hepatitis E Virus to Blood Supply Safety’, and he was supervised by Dr Helen Faddy and Prof. Robert Flower at the Blood Service. Katrina Ki was awarded her PhD from the University of Queensland for her thesis entitled ‘Characterisation of dendritic cell immune profile in models of transfusion.’ She was supervised by A/Prof. Melinda Dean, Prof. Robert Flower and Dr Helen Faddy. Ms Amelie Babinet completed requirements for her Master’s in Biotechnology of Health at ONIRIS (College of Food and Health Science and Technology Engineering), France, while working with the R&D team in Brisbane. Her project ‘Red cell storage’ duration and procoagulant effects: Role of microparticles and smaller particles was supervised by Marie Anne Balanant, Dr John-Paul Tung and Prof. Robert Flower at the Blood Service, with Dr Natalie Pecheniuk from Queensland University of Technology.

Four honours students, Dr Rachel Colbran, Elise Gorman, Assia Moussa and Lauren Waters, successfully completed this year, with all receiving first class honours. Of particular note, Dr Rachel Colbran received first class honours concurrent to her MBBS, and was Valedictorian for The University of Queensland School of Medicine. Her thesis was titled ‘Making every question count: the impact of temporary donor deferral for suspected acute retroviral syndrome’. She was supervised by Dr Helen Faddy, A/Prof. Melinda Dean, Prof. Robert Flower and Dr Robert Harley. We can expect further higher degree completions in the years to come, with Annette Sultana and Alexis Perros completing their Mid-Candidature Review PhD milestone, and Gabriela Simonova completing her Confirmation PhD milestone this year, and a total of 19 PhDs currently in progress across the group. A full listing of all students, projects and supervisors appears in Appendix 4.

AWARDS PRESENTED TO BLOOD SERVICE RESEARCHERS 2016-2017 Awardee

Appendix 3 - Abstracts accepted for oral or poster presentations 60 Appendix 4 - Student projects 66 Appendix 5 - Collaborations 70

Sharing our results with others extends the impact of our research beyond the walls of the Blood Service. To this end, our team this year published over 50 peer reviewed publications, and presented 96 conference presentations, including nine oral presentations at the ISBT congress in Copenhagen, and three at AABB in Orlando.

Kathleen Chell was awarded her PhD from the Queensland University of Technology (QUT), supervised by Dr Geoff Smith at the Blood Service, and by Prof. Rebekah Russell-Bennnet and Dr Gary Mortimer at QUT. Her thesis was titled, ‘Giving and sharing: the predictors and outcomes of online donor appreciation’.

Our team are actively engaged in the Australian and international scientific communities

Name of award

Date awarded

Dr Celine Loh

CSL Behring Overseas Travel Grant

August 2016

Dr Rachel Colbran

MBBS Valedictorian

August 2016

Genghis Lopez

ANZSBT Travel Grant

August 2016

Dr Rena Hirani

HAA Travel Grant

November 2016

A/Prof. Catherine Hyland

ANZSBT Travel Grant

November 2016

Yu Ji

Queensland University of Technology Research scholarship

December 2016

Eunike McGowan

University of Queensland Research Training Program Scholarship

January 2017

Ibrahim Tohidi-Estafani

DS Nelson Trainee Prize (presented by RCPA)

February 2017

Annette Sultana

The Prince Charles Hospital Foundation PhD scholarship

March 2017

Monica Ng

The Prince Charles Hospital Foundation PhD scholarship

March 2017

Eileen Roulis

Queensland University of Technology Outstanding Doctoral Thesis Award

April 2017

A/Prof. Melinda Dean

American Association of Immunologists Travel for Techniques award

April 2017

Marie Anne Balanant

Harold Gunson Travel Award (ISBT)

April 2017

MEET OUR RESEARCH LEADERS

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

OUR DIRECTOR

DONOR RESEARCH

DONOR BEHAVIOUR

DONOR HEALTH AND WELLBEING

PRODUCT DEVELOPMENT AND STORAGE

Prof. David Irving Director, Research and Development

Dr Tanya Davison National Donor Research Manager

A/Prof. Barbara Masser Visiting 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.

Dr Stephen Wright Honorary Research Fellow (Biostatistics)

A/Prof. Denese Marks

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.

Dr Barbara Bell Donor Vigilance & Clinical Research Manager

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.

A/Prof. 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.

DONOR BEHAVIOUR

PRODUCT DEVELOPMENT AND STORAGE

Dr Nina van Dyke Research Fellow

Dr Alison Carver Research Fellow

Dr Anne van Dongen Honorary Research Fellow

Dr Lacey Johnson Principal Research Fellow

Dr Dianne van der Wal Senior Research Fellow

Dr Celine Loh Research Fellow

Nina has conducted research for a variety of academic institutes, not-for-profit organisations, and research companies both in Australia and the United States. For the past 10 years her research has focused on public health and behaviour change. She also has a particular interest in survey methodology. She joined the Blood Service in November 2016.

Dr Carver’s current research focused 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.

Originally from the Netherlands, Dr van Dongen worked at the Dutch Blood Service Sanquin for 10 years. She obtained her PhD in Health Psychology, focusing 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.

Dr Johnson completed her PhD at The University of New South Wales, which focused 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 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 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.

With formal training in biochemistry, cell and molecular biology and management, Professor Irving has over 25 years’ experience in the biomedical and life sciences. 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.

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.

National R&D Leader - Product Development and Storage

Dr Carver left the Blood Service during 2016-2017.

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

PRODUCT DEVELOPMENT AND STORAGE

PRODUCT SAFETY

THE YEAR IN REVIEW

Dr Kelly Winter Research Fellow

Dr Joanne Tan Research Fellow

Dr John-Paul Tung Senior Research Fellow

Dr Elvina Viennet Research Fellow

Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

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.

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.

Prof. Robert Flower National R&D Leader – Product safety

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.

Dr Viennet completed a Doctor of Philosophy degree in Medical and Veterinary Entomology and Bio-Ecology from CiradCMAEE, 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.

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

Prof. Flower’s research focuses broadly on transfusion safety, with teams using in vivo and in vitro models to investigate impacts of transfusion as well as the application of genotyping to improve pregnancy management and the matching of blood for patients.Robert has a strong commitment to education of both undergraduate and postgraduate students.

PRODUCT SAFETY

PRODUCT USAGE

Appendix 3 - Abstracts accepted for oral or poster presentations 60

Dr Elizna Schoeman Research Fellow

A/Prof. Catherine Hyland Principal Research Fellow

A/Prof. Melinda Dean Senior Research Fellow

Dr Helen Faddy Senior Research Fellow

Elizabeth Knight Clinical Research Project Manager

Dr Wayne Dyer Senior Research Fellow

Dr Rena Hirani Research Fellow

Appendix 4 - Student projects 66

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.

A/Prof. 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 the use of genetic techniques to characterise novel blood group antigens and to solve complex blood group typing problems.

A/Prof. Dean received her PhD from the University of Queensland 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 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.

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.

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.

Appendix 5 - Collaborations 70

Elizabeth has a Science degree in physiology and pharmacology and a Master’s in Public Health from the University of Wollongong. She has over 15 years’ experience working in the clinical trial environment, including three and a half 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.

Our team’s expertise supports the growing need for plasma

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

DONOR BEHAVIOUR Donors are literally the lifeblood of the Australian Red Cross Blood Service, and knowledge of how to support people to make the life-changing decision to become, and then to remain, a blood donor is essential. Australia is one of the few blood services in the world to have established a donor research program, and our team includes researchers with expertise across public health psychology, sociology, statistics, economics and marketing. The Donor Research team includes researchers with co-appointments to major universities, including the University of NSW (psychology), the University of Technology, Sydney (biostatistics), and the University of Queensland (psychology). The Donor Research team has strong expertise in the complex motivations underlying blood donation. This information ensures that communications are appropriately framed to engage wouldbe donors and support them through the process of making an appointment and actually presenting to donate on the day, and encourage them to return. 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: PREVIOUS PAGE

•

Donor recruitment

•

Donor retention

•

Plasmapheresis donation

DONOR RECRUITMENT In 2016-2017, the Donor Research team completed projects designed to improve our engagement with young male donors and Gen Y donors, and studied the impact of incentives on blood donation. Young male donors, who are typically less responsive to marketing campaigns than other groups, currently make up a relatively small proportion of the donor panel. This year we completed the first systematic review of the literature on why men donate blood, bringing together findings from 28 research studies. In addition, a collaborative project with the Marketing department generated some key learnings for how to engage with this traditionally challenging group. A second large project completed this year, representing the culmination of a long-standing collaboration with marketing researchers at Queensland University of Technology, was led by Professor Rebekah Russell-Bennett. This multi-faceted project focused on service expectations held by Generation Y donors. This knowledge is important for the business to ensure that the Blood Service is well positioned to engage with our donors of the future. In response to requests from colleagues in Donor Services and the expanding Plasma program, we applied our expertise

to examine the use of incentives (both monetary and non-monetary) in blood donation. This project involved a systematic review of existing literature on incentives and donors’ and non-donors’ attitudes towards the use of incentives. Research literature on whether incentives are effective in increasing rates of recruitment and return donation was also reviewed, as were studies determining whether the use of incentives is associated with an increased risk of transmittable infections. Following from this analysis of the existing literature, the Donor Research team will conduct a survey of donors’ and non-donors’ attitudes towards the use of (non-monetary) incentives in Australia, which is scheduled for 20172018, to guide the business into the future.

DONOR RETENTION It’s important not just to get donors ‘in the door,’ but also to keep them coming back. Return donors provide safety and cost advantages over newly recruited donors, and allow for more accurate forecasting. Yet approximately 40 per cent of first-time whole blood donors and 22 per cent of firsttime plasmapheresis donors do not return within a two year period. The Donor Research team is therefore actively engaged in understanding why donors do and do not return and in designing evidence-based interventions to increase donor retention. This area of

Every three weeks, Jesse, Katiah-Ann and Sonny receive plasma donations to manage their autoimmune disease. They’re grateful to donors for helping them be happy, healthy kids.

research spans the new donor experience, how best to retain our existing high frequency donors, strategies to prevent loss of donors and ways to reactivate those who have lapsed but may still be willing to donate.

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

One of the largest projects in the Donor Retention area is a Linkage Project, funded by the Australian Research Council, to better understand the role of emotions in promoting donor retention. This study is being conducted in collaboration with Dr Lisa Williams at UNSW. Blood donation generates strong and varied feelings, yet the role of emotions in promoting blood donor retention has largely been ignored in the academic literature to date. The Donor Research team and their collaborators are leading the way internationally on this important topic. Data collection has been completed for the first study, which determines the emotions experienced by novice donors at key points during their donation experience (pre-donation, during donation, and post-donation in the refreshments area). By tracking which emotions predict the return behaviour of these new donors, the researchers will be able to develop and test interventions designed to improve donor retention. Additional studies of the emotions of donors over the months following donation, and those who haven’t returned to donate for several months, will lead to further interventions. A second study in the area of donor retention focuses on determining why donors lapse, in order to inform the development of interventions to keep donors coming back. This study focuses on segments of the donor panel that are critical to the Blood Service, especially donors who have lapsed following a temporary deferral and O negative donors. The research team has already identified key changes in practice that will encourage donors to return following their deferral period. The research recommendations are being translated to the business through an effective collaboration across Donor Services, the National Contact Centre, and Medical Services. Learnings from this study will lead to a targeted intervention that will be evaluated by the Donor Research team during 2017-2018. A third study aims to improve the retention of valuable O negative donors in the target group of 18-39 year olds. This is a collaborative project with leading health psychologist, Professor Christopher France at the University of Ohio. It will test a

PLASMAPHERESIS DONATION

targeted online intervention for first-time O negative donors based on the principle of motivational interviewing, originally developed by Prof. Chris France. Phase 1 of this project, which was used to inform the content of the online psychological intervention, consisted of interviews with first-time O negative donors and was completed in March 2017. Phase 2 will provide an evaluation of the online tool in an Australian context to test whether it encourages donors to return to give another blood donation.

The need to recruit and retain plasmapheresis donors is of critical importance, with plasma collection now a key focus of the Blood Service. Demand for plasma derived products has increased dramatically since 2003-2004, resulting in Australia moving from self-sufficiency in the supply of these products to a situation where 40 per cent of these products are now imported. To maintain this level, and ideally reverse this trend, plasma collections need to expand rapidly. This expansion will occur both by increasing the proportion of eligible Australians who engage in plasmapheresis, as well as by improving the retention of plasmapheresis donors and increasing the frequency of their donations. Our team’s expertise supports the growing need for plasma. While globally, many donor researchers have traditionally focused predominantly on whole blood donation, the Donor Research team is recognised internationally for its expertise in the behaviour of plasmapheresis donors, through the work led by Associate Professor Barbara Masser (University of Queensland), and this critical panel continues to be a primary focus for the team. To date, Blood Service marketing has refrained from providing information on apheresis to new donors, due to concerns about overwhelming this group. However, with an increasing focus on ‘converting’ whole blood donors to plasmapheresis earlier in their donation careers, such information may be sought by donors. This year, our research team trialled

the inclusion of information on the plasmapheresis process in Welcome Packs provided to new donors. We found that this information could be safely provided with no negative impact on future donation behaviour. A second, ongoing study focuses on improving the retention of successful first-time plasmapheresis donors in the panel. The first phase of this project involved interviews with first time plasmapheresis donors to understand why they decide to return (or not) for a second donation within a range of timeframes. The second phase will use these findings to develop and test simple interventions, designed to increase return rates and encourage new plasmapheresis donors to donate at an increased frequency. Looking to the future, we’re trialling the use of virtual reality technology to encourage whole blood donors to try plasmapheresis. This innovative use of a new technology may prove more engaging than traditional media, such as videos or brochures, as it allows donors to gain a more realistic understanding of the plasmapheresis process. The Media team have used previous findings from the Donor Research team to produce a virtual reality video, targeted to address the concerns of donors about plasmapheresis. Data collection to determine the feasibility of using this technology in a donor centre is underway.

By donating plasma, Chris inspires his students to learn more about blood donations and how they can make a difference.

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

CALLING YOUNG MALES Young men are in demand as blood donors, but they are not fairly represented in our donor panel. How can we get more of these potential heroes through the doors of our donor centres? One solution suggested by our research might involve getting their mates to bring them in. The Blood Service particularly wants to recruit men under 40 because, compared with women, they are less likely to experience adverse reactions to donation, such as fainting and dizziness. Men are also preferred donors of clinical plasma due to the increased risk of Transfusion Related Acquired Lung Injury (TRALI) from transfusion of plasma from women who have ever been pregnant. Dr Tanya Davison explains the study, â&#x20AC;&#x153;When we reviewed the work of other scientists in this field, we found that men are more likely to donate when they are encouraged by family members or friends who are donors themselves. We then asked young Australian males who had never donated blood before what might actually motivate them to donate blood. Many said they were unlikely to take the first step to donate blood on their own, similar to the results in international studies. Instead they said they were more likely to act if encouraged or supported by other people, and if someone else made arrangements for them such as booking the appointment and organising transportâ&#x20AC;?

PROJECTS Donor research projects arranged by key research area, showing Blood Service Researchers. All our collaborators are listed in Appendix 5. DONOR RECRUITMENT

DONOR RETENTION

PLASMAPHERESIS DONATION

COMPLETED PROJECTS

ONGOING PROJECTS

DB15-02 Recruitment of male donors

DB16-04 Hospitals to hospitality Understanding the influence of interaction with staff and service quality on donor intention to donate

DB16-01 Development and evaluation of interventions to improve first-time plasma donor retention

Dr Alison Carver, Dr Tanya Davison, A/Prof Barbara Masser, Dr Kathleen Chell DB16-02 Informing new donors about different donation types

Dr Tanya Davison

A/Prof. Barbara Masser, Dr Tanya Davison, Dr Nina Van Dyke

Dr Alison Carver, Dr Tanya Davison, A/Prof. Barbara Masser, Carley Gemelli, Carmela Germano donation types

ONGOING PROJECTS

ABANDONED

DB15-04 Emotional psychology of blood donors (ARC)

DB15-03 Behavioural economics to better understand plasma and bone marrow donations

Dr Anne van Dongen, Amanda Thijsen, A/Prof. Barbara Masser, Dr Tanya Davison DB16-03 Why do donors lapse? Developing an understanding of critical segments of the donor panel to inform practice Carley Gemelli, Dr Tanya Davison, Dr Nina Van Dyke, Kyle Jensen DB16-06 Pilot trial of an innovative online intervention with first time O negative donors A/Prof. Barbara Masser, Dr Tanya Davison, Dr Nina Van Dyke, Kyle Jensen

DONOR HEALTH AND WELLBEING

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

The ongoing health and wellbeing of our donors is one of our highest priorities. This research theme focuses on the prevention and management of donation-related adverse events, interventions to improve the donation experience, and promotion of long-term donor health. Research in this theme is divided into key research areas:

IMPROVING BLOOD DONATION PRACTICES

•

Reducing donor adverse events

•

Improving blood donation practices

•

Data linkage

•

New donation options for donors.

The Donor Research team has a keen interest in improving the experience of all Australians who donate blood, with the point of blood draw itself being a key aspect of the donation experience. Three projects were commenced during 2016-2017 with a view to improving this aspect of donation.

REDUCING DONOR ADVERSE EVENTS This key research area focuses on the prevention of donor adverse events by introducing prevention techniques into routine blood collection practices. This program of research takes a holistic approach, using qualitative and quantitative techniques to explore the knowledge and behaviours of both donors and collection staff. This year our researchers tested materials to educate donors about how to avoid adverse events during donation. They worked collaboratively with Donor Services staff to evaluate donor educational materials (instruction card, video, webpage) and found that an instruction card provided in centre, combined with staff support was the most effective method. These findings will be implemented during a national translational trial in 2017-2018.

The first project investigates a non-invasive device called Coolsense® that is designed to reduce the pain of needle insertion. Previous research by the Donor Research team indicates that fear of needles or concern about painful needles is a common barrier to blood donation. Moreover, donors who do experience a painful phlebotomy are at an increased risk of symptoms such as nausea or dizziness, during or following their donation, and many of these donors withdraw from blood donation altogether. Thus, interventions that reduce the pain associated with blood donation could potentially assist in both recruiting new donors, and in ensuring that donors return to donate again in the future. The Donor Research team has commenced a three stage program of research that includes (i) testing the safety of the Coolsense® device, (ii) ensuring the device is feasible for use in Australian donor

Appendix 5 - Collaborations 70

We’re testing new ways to educate donors about how to avoid adverse events during donation.

centres, and (iii) evaluating the efficacy of the device in a rigorous randomised controlled trial. The second project relates to the importance of ensuring that donors have suitable veins prior to a phlebotomy proceeding. The Donor Research team is assisting Dr Philip Mondy, Medical Specialist in Clinical Services and Research, to evaluate a classification method to enable staff to assess the suitability of donors’ veins. This method is likely to be of particular benefit in training new phlebotomy staff to assess the suitability of individuals to give a successful blood donation. The third project trials non-invasive technologies to test donor haemoglobin levels. Currently, the Blood Service tests haemoglobin levels using a finger prick, which many donors find painful. Other blood collection agencies use non-invasive haemoglobinometers for this purpose. The availability of several new technologies in this field warrants a systematic investigation prior to the introduction of any new technology. This trial commenced in a donor centre at the end of 2016-2017, and results will be available to inform practices in 2017-2018.

DATA LINKAGE 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 ongoing and frequent blood donation. Through collaboration with the Sax Institute, the Blood Service is linking donor records with information from the 45-and-up study and other large health databases including the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Scheme (MBS), disease registers, and admitted patient hospital records. The linked datasets will provide a valuable resource to examine whether there are any risk-associations or protective-effects between blood donation and cardiovascular risk, bone fractures and other common ageing related morbidities. The first stage of the linkage project is almost completed. Of 150,000 ‘eligibleto-donate’ 45-and-up study participants, approximately 40,000 were linked, and projects exploring associations between blood donations and ageing related morbidities are due to start soon. This project represents the first instance of a large-scale data linkage exercise at the Blood Service.

NEW DONATION OPTIONS FOR BLOOD DONORS Global demand for platelet and plasmaderived products including intravenous immunoglobulin (IVIg) continues to grow steadily. In contrast, medical advances and

improvements in patient blood management have decreased requirements for red cell products. With less collections required to meet red cell inventory, the amount of fractionated plasma available from whole blood donations has been reduced. These factors have shifted donor centre operations from a primary focus on whole blood collections to an increased effort to recruit and retain apheresis donors to meet future demand. To address future demand, Blood Service Research & Development developed and led the first ever trial of first attendance plasmapheresis in a non-remunerated setting. Under the current Blood Service policy, all first time donors must give a whole blood donation in the first instance, prior to a plasmapheresis donation. Of interest to the Blood Service are the implications of providing first time donors with an option to donate plasma instead of whole blood, particularly in terms of changes in the rates of adverse events and donor retention. Recruitment of over 800 new donors to first-time plasmapheresis was completed in June 2017, and follow up of these donors will continue for six months, with final results expected early 2018. The Blood Service is also currently researching different donation options, including triple platelet apheresis collections.

Simoneâ&#x20AC;&#x2122;s mother encouraged her to donate plasma when she was 18. Now, her daughter relies on plasma donations in her fight against leukaemia.

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

PROJECTS Donor Health and Wellbeing projects arranged by key research area, showing Blood Service researchers. All our collaborators are listed in Appendix 5. REDUCING DONOR ADVERSE EVENTS

DATA LINKAGE

COMPLETED PROJECTS

ONGOING PROJECTS

DH15-01 A trial of interventions to increase adherence to applied muscle tension during whole blood donation

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

Amanda Thijsen, Jenny Fisher, Carley Gemelli, Dr Barbara Bell,

APPENDICES

A/Prof. Barbara Masser, Dr Tanya Davison

ONGOING PROJECTS DH16-03 Reducing vasovagal reactions in whole blood donors through the introduction of applied muscle tension in routine staff practices: a randomised controlled trial Amanda Thijsen, A/Prof. Barbara Masser, Dr Tanya Davison, Carley Gemelli, Barbara Bell

DH16-01 Iron Stores, Blood Donation, and Long-term Health Outcomes Dr Stephen T. Wright, Dr Tanya Davison, Carley Gemelli DH16-02 Frequent Apheresis Donation and Long-term Health Outcomes in Older NSW Blood Donors Dr Stephen T Wright, Dr Tanya Davison

DH16-05 Does oral iron polymaltose cause hypophosphataemia in blood donors?

NEW DONATION OPTIONS FOR DONORS

Dr Joanna Speedy, Dr Jo Pink, A/Prof. Denese Marks, Dr Sant-Rayn Pasricha

ONGOING PROJECTS DH15-05 Safety and feasibility of first appointment plasmapheresis donation

IMPROVING BLOOD DONATION PRACTICES ONGOING PROJECTS DH16-04 Donor Haemoglobinometer Evaluation A/Prof. Denese Marks, Dr Barbara Bell, Andrew Scott DH16-06 A pilot trial of the CoolsenseÂŽ pain numbing device in phlebotomy Dr Tanya Davison, Carley Gemelli, Liz Knight, Kyle Jensen

Dr Stephen Wright, Carley Gemelli, Dr Janet Wong (to be confirmed), Dr Tanya Davison, Prof. David Irving

Elizabeth Knight, Prof. David Irving, Dr Alison Carver, Dr Tanya Davison, Dr Stephen Wright, Dr Barbara Bell

SECURING PLASMA SUPPLY

The need for plasma is growing, and to help meet this demand, Blood Service Research & Development developed and led the first ever trial of first attendance plasmapheresis in a non-remunerated setting. Under the current Blood Service policy, all first time donors must give a whole blood donation, prior to a plasmapheresis donation. What would happen if we allowed first time donors to give plasma? Would they return at the same rate? Would there be an increase in adverse events? The ADOPT study aimed to answer these questions. Specifically, ADOPT was a cluster randomised trial to assess that compared the tolerability of plasmapheresis against whole blood donation in first time donors. The study was restricted to donors over 30 years of age. It measured donor satisfaction,

retention rate at six months and donor safety in 1400 donors (650 whole blood and 750 plasma). Recruitment for the study was completed in June 2017, and at that time, there were no significant safety concerns, and adverse events for first time plasma donors were no higher than expected. The study included a planned total of 750 new plasmapheresis donors, across 10 sites. There will be a six month follow-up period to make sure donors are happy to return after experiencing plasmapheresis at their first appointment. Data from this study will be used as evidence for a national roll out of first attendance plasmapheresis donation by Donor Services as the Blood Service endeavours to meet the increasing demand for plasma products.

We maximise the potential of each donation

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

PRODUCT DEVELOPMENT AND STORAGE The Product Development and Storage team maximise the potential of each donation by developing new and more efficient ways to process and store blood components, improve product quality and develop new products to meet demand and reduce waste. Members of this team work closely with other Blood Service divisions as well as with external collaborators from other institutions to conduct research that focuses on blood component development and quality and improvements in operational efficiency. Projects within this theme develop and optimise robust protocols that can be translated to the Manufacturing and Donor Services Divisions of the Blood Service, which are integral to our core business. Product Development and Storage research is divided into three key research areas: •

Conventional components

•

Extended component storage

•

Novel Products

CONVENTIONAL COMPONENTS PREVIOUS PAGE

The conventional components theme comprises projects that focus on gaining further knowledge and improving our current components, or ‘doing what we do better’.

The conventional components research area identifies key areas where there is potential to improve or better understand the quality of our current components, or where collection and processing methods can be made more efficient. The Product Development and Storage research team have strengthened our collaborations with the manufacturing division of the Blood Service this year, working together on numerous continuing projects. We have embarked on a new collaborative project to evaluate the quality of components at ambient temperature during processing steps, initially focusing on the processing of plasma and plasma components. Product Development and Storage researchers have evaluated the quality of triple dose platelet collections, as part of a collaborative project led by Donor Services, contributing to a key efficiency-driven project. Recruitment in the Frequent donation, iron deficiency and red cell storage project has been strong with 138 of 300 donations

collected in the last six months. An interim analysis will be conducted at the halfway point. So far 25 platelet donors have been recruited into the Identifying the best donors for our platelet components study. For the four donors who have so far returned for a second donation, the in vitro testing correlated between the first and second donations. The Quality Monitoring Program is now in its third year and we have continued to test pooled platelets from all four Blood Service processing centres (Sydney, Brisbane, Melbourne and Perth). This data has been very valuable in monitoring trends that otherwise would not be observed from routine testing.

EXTENDED COMPONENT STORAGE Projects within the extended component storage theme are focused on assessing technologies and developing strategies to extend the shelf-life of blood products. Much of the work in this theme is focused on cryopreservation and cold storage

of blood products. Cryopreservation is an attractive alternative method for blood product storage, as it enables a considerable extension of the product shelf-life, compared to liquid storage. This research theme 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 under investigation. It’s essential to understand any biochemical and functional alterations in the cells within the components that may occur as a result of cryopreservation or refrigeration, and to determine how these changes may influence their clinical utility. This year our expertise in storing platelets under refrigerated conditions has expanded. We now have data demonstrating the effects of storing pooled and apheresis platelets in the cold for up to three weeks. Further, we have explored the possibility of delaying cold storage to maximise platelet inventory. The results of these studies have been received very enthusiastically by internal stakeholders, as well as internationally.

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

An international collaborative study conducted under the auspices of the Biomedical Excellence for Safer Transfusion (BEST) has been completed. This project, led by Dr Lacey Johnson, in collaboration with Dr Larry Dumont, included participants from the USA, New Zealand and Scotland, evaluated additive solutions for reconstitution of cryopreserved platelets. Data from this study suggests that cryopreservation processes used internationally and in Australia are robust, such that differences in manufacturing methods may not greatly influence the quality or function of cryopreserved platelets. Methods for freezing sheep platelets have been optimised based on those developed for freezing human platelets. The ability to freeze sheep platelets will allow them to be utilised in the well-established sheep transfusion models. Investigating frozen platelets in this model will provide essential pre-clinical data regarding the ability of frozen platelets to regulate bleeding.

APPENDICES

NOVEL PRODUCTS Projects within this theme focus on the development and characterisation of novel products that are either 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. A large proportion of this theme is focused on producing platelet gels and lysates from expired platelets. Platelet lysate has been identified as a substitute for bovine serum in the culture of human mesenchymal stem cells intended for therapeutic use. The benefits of developing these novel products will be the development of new business lines for the Blood Service and reduction of wastage when expired products are used, as is the case for platelet lysates and gels. Our team was invited to participate in an International Forum on the manufacture of platelet lysate, which will be published

in the journal Vox Sanguinis. Collaborators who have tested our platelet lysate were extremely satisfied with the product and several have requested for more product for larger scale testing. Technology transfer for the production of 10 L research grade platelet lysate has been initiated at the Blood Service.

NEW USE FOR WASTE With the growth of new stem cell-based therapies, there is an increased demand for material to feed stem cells as they grow. This material needs to be rich in growth factors and nutrients, and ideally should not be derived from animal sources to minimise the chance of transmission of animal-borne diseases to patients. Platelet lysate, produced from expired platelets, is a potential novel product that can be used for this purpose. The Product Development and Storage team are developing a process to produce platelet lysate using expired platelet concentrates.

So far our findings indicate that platelet lysate produced from expired buffy coat derived platelets is very effective in supporting the growth of therapeutic stem cells.

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59

A method to produce a large volume of platelet lysate for commercial purposes is currently being developed.

Appendix 3 - Abstracts accepted for oral or poster presentations 60

The image shows stem cells that have been grown in platelet lysate. These cells maintain their ability to develop into adipose (fat) cells. The red in the picture shows fat production in the cells.

Appendix 4 - Student projects 66 Appendix 5 - Collaborations 70

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

PROJECTS Projects listed by key research area, showing Blood Service researchers. All our collaborators are listed in Appendix 5. CONVENTIONAL PRODUCTS

EXTENDED COMPONENT STORAGE

NOVEL PRODUCTS

ONGOING PROJECTS

COMPLETED PROJECTS

ONGOING PROJECTS

PD14-01 Quality Monitoring Program (QMP)

PD14-07 Improvements to red cell cryopreservation

PD14-09 Development and characterisation of platelet lysates

A/Prof. Denese Marks

Dr Kelly Winter, Dr Lacey Johnson, A/Prof. Denese Marks

Dr Celine Loh, A/Prof. Denese Marks

PD15-02 Evaluation of new plasmapheresis systems

ONGOING PROJECTS

Dr Kelly Winter, A/Prof. Denese Marks PD16-01 Frequent donation, iron status and the red cell storage lesion: Is there a link? Dr Joanne Tan, A/Prof. Denese Marks, A/Prof. Cate Hyland and Dr Helen Faddy PD16-02 Pilot study to determine whether in vitro testing can identify the best donors for our platelet components Dr Dianne van der Wal, A/Prof. Denese Marks and Dr Lacey Johnson

PD14-04 Characterisation of cryopreserved platelets Dr Lacey Johnson, A/Prof. Denese Marks, Dr John-Paul Tung, A/Prof. Melinda Dean PD14-05 Cold storage of platelets Dr Lacey Johnson, A/Prof. Denese Marks, PD14-06 Frozen blood stability testing Lacey Johnson, A/Prof. Denese Marks, Dr Janet Wong PD14-08 Anaerobic red cell storage Dr Joanne Tan, A/Prof. Denese Marks

Appendix 4 - Student projects 66

PD15-01 Extending the shelf-life of FFP and cryoprecipitate Dr Kelly Winter, A/Prof. Denese Marks, Dr Janet Wong

Appendix 5 - Collaborations 70

PD15-03 Use of additive solutions for reconstitution of cryopreserved platelets Dr Lacey Johnson, A/Prof. Denese Marks PD15-04 Biomimetic blood bag materials for prolonged platelet storage

Dr Lacey Johnson, Prof. David Irving, A/Prof. Denese Marks

PD14-10 Development and characterisation of platelet gels Dr Celine Loh, A/Prof. Denese Marks

TRANSFUSION TRANSMITTED INFECTIONS AND EMERGING RISKS

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

PRODUCT SAFETY Members of the Product Safety research team apply expertise to a broad range of problems related to blood safety, including transfusion transmitted infections, the causes of adverse reactions to transfusions and methods to better match donors to patients using genetic technology. Our focus ranges from the whole patient, down to immunological models and application of the most advanced molecular genetic analyses. In our work we welcome collaborations both within and external to the Blood Service, providing the Blood Service with access to world-leading multi-disciplinary expertise, and broadening the reach of our research. This year saw the commencement of operations of the Australian Red Cross funded Centre for Biopharmaceutical Innovation in which the Blood Service is a partner. In this centre a number of staff and

students are working between the University of Queensland and the Blood Service, in a collaborative centre that involves multiple industry partners. Other collaborations are also in progress with UQ, QUT and Griffith University including Physics, Engineering and Biomedical Science. A key new initiative is development, by a cross-divisional project team, of an assay to measure the risk of antibodies to red blood cells leading to red cell destruction and thus

to measure and minimise the risk of transfusion reactions in patients. The Product Safety team continue to recruit outstanding postgraduate students and obtain significant external funding. These successes underpin our leading edge outcomes that translate into evidence-based advice to the organisation and the sector, and ultimately to improved safety for patients.

Transfusion safety can be impacted by emerging risks, including those with an infectious origin. Many transfusion risks have become global; however, unique region-specific concerns exist. This research theme investigates possible risks to the Australian blood supply, which allows the development of appropriate management strategies for future-proofing our blood supply against emerging threats. The team has continued to generate evidence in relation to whether hepatitis E virus (HEV) poses a risk to the Australian blood supply. This year we have shown that Australian donors have the lowest published rate of HEV viremia in the world. The team used these data along with a transmissionrisk model to estimate a very low risk of an adverse outcome associated with transfusion transmitted HEV. The results of this study indicate HEV blood donor testing is currently unwarranted and we are currently seeking stakeholder feedback. Due to the global emergence of Zika virus, as well as reports of transfusion transmission, the team is also heavily involved in research on this agent. We continued our Pathogen Inactivation (PI) studies and demonstrated that the THERAFLEX PI systems can reduce Zika virus infectivity in platelets and plasma, suggesting such systems have capacity to manage potential Zika virus transfusion transmission risk. The team is also undertaking research to determine the probability of Zika virus transmission in Australia and impact on blood safety. Our global influence in the field of transfusion transmitted infections is evidenced by the fact that Dr Helen Faddy represented Australia and the Blood Service at a WHO consultation on ‘Estimating the impact of emerging infections to the blood supply: requirements for risk estimation and decision making support’ held in Geneva 14-15 June 2017.

UNDERSTANDING THE PATHOGENESIS OF ADVERSE TRANSFUSION REACTIONS — ROLE OF THE IMMUNE SYSTEM There’s 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. These clinical trials are not designed to investigate underlying mechanisms of adverse reaction.

Blood Service research in this area utilises both laboratory models of transfusion and clinical samples from transfusion recipients to examine the mechanisms that lead to adverse transfusion reactions. The team has developed a number of relevant transfusion models and made significant contributions in this important area of transfusion medicine. Of note, this year has seen the establishment of methods for the detection of the activation of inflammasomes, which are protein assemblies that activate an inflammatory cascade. These novel assays will allow us to study some of the adverse effects of transfusion in a whole-blood laboratory model.

IMPROVING IDENTIFICATION OF BLOOD GROUPS BY GENOTYPING Blood groups are inherited, with different frequencies and patterns in different ethnic groups. Human blood group antigens are of significance in transfusion medicine because patients who have made anti bodies to red cell antigens are at risk of being affected by haemolytic transfusion reactions following transfusion of incompatible blood. The Red Cell Reference Laboratory (RCRL) employs serology and single nucleotide polymorphism genotyping technology to solve complex red blood cell cases. When these approaches fail to resolve the case, further avenues of investigation are required. The team has validated a Massively Parallel Sequencing (MPS) approach to improve the identification of blood groups by genotyping 33 of the 36 blood group systems in a single test. This approach has been used to assist the Red Cell Reference Laboratory to solve more than 50 complex serology cases over the past year. Of particular interest was a case from Thailand, where the investigation of an unusual patient antibody led to the discovery of a new high-frequency blood group antigen, known as JENU, and designated as MNS49. This blood group antigen is present in over 90 per cent of the population, and was officially recognised by the International Society for Blood Transfusion Reference Group in late 2016. The analysis of genomic data has also allowed blood group information to be predicted from anthropological samples, such as 100 year-old locks of hair and finger bones of Denisovan humans.

OPTIMISING TRANSFUSION SUPPORT FOR NEONATES AT RISK OF HAEMOLYTIC DISEASE OF THE NEWBORN

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

In order to optimise transfusion support for neonates at risk of haemolytic disease of the fetus and newborn (HDFN), the team has extended their previous work with RhD genotyping to develop sensitive new maternal blood tests using droplet digital PCR. These tests allow non-invasive prenatal analysis for the detection of further clinically significant fetal blood groups (K, c, and E and HPA-1a) where there is a suspected fetal/mother mismatch. These assays are currently being validated on a library of samples from alloimmunised cases in collaboration with the Mater Mothers’ Hospital, the Mater Medical Research Institute and the High Risk Obstetrics Royal Prince Alfred Hospital and Obstetrics. A cost-benefit analysis of the use of genotyping to reduce anti-D immunoglobulin use was completed,

predicting that non-invasive RhD genotyping for RhD negative women during pregnancy would produce substantial cost savings for the National Blood Authority, while remaining cost-neutral to the health system as a whole.

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.

REDUCING THE RISKS ASSOCIATED WITH TRANSFUSION Blood transfusion is essential to modern medicine. However, it’s not without risk and transfusion has been associated with an increased risk of illness and death in certain patient groups. This theme of 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 outcome.

AUSTRALIA HAS THE LOWEST PUBLISHED RATE OF HEV IN THE WORLD

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59 Appendix 3 - Abstracts accepted for oral or poster presentations 60 Appendix 4 - Student projects 66

HEV can cause water-borne hepatitis outbreaks in developing countries. In developed countries, HEV can be transmitted by eating undercooked contaminated meat, particularly pork and pork products or through contact with animals, typically pigs. Infection sometimes causes symptoms such as vomiting, diarrhea, jaundice and liver swelling,

Appendix 5 - Collaborations 70

In recent years, the detection of hepatitis E virus (HEV) infection has increased in developed countries, and higher than expected infection rates have been found in blood donors around the world. The Blood Service doesn’t routinely test for HEV because, although common worldwide, it is not thought to be commonly acquired in Australia. A recent study, led by Dr Helen Faddy from R&D in collaboration with colleague Dr Veronica Hoad from the Donor and Product Safety Unit, investigated how prevalent the virus is in Australia, to make sure we’re doing everything we can to ensure our blood supply remains safe.

but in developed countries the majority of infected individuals don’t show any symptoms. Transmission of the virus through blood transfusion is possible, and has been demonstrated several times overseas. “We wanted to find out whether any of our whole blood donors were infected with HEV,” explains Helen. “We collected an extra plasma sample from 74,131 whole blood donors across Australia between May and November, 2016. We tested for the virus in the donor blood samples by looking for its genetic material (RNA). Because we only detected the virus in one donation from this large group of donors, we concluded that the risk of collecting a HEV infected whole blood donation in Australia is low, and much lower than the risk in other developed countries. The very low prevalence found suggests universal or selective HEV blood donation screening in Australia is not currently needed.”

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 theme of 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. Our research has used various techniques to measure the effects of ageing on red blood cells, including the introduction of ‘optical tweezers’, which enable us to measure the energy required to stretch a captured red blood cell between two laser beams. Using this tool, we discovered that the stretching of a red blood cell membrane does not follow a linear elastic deformation, but shows ‘energy thresholds’ where the force required to maintain the stretch of the membrane decreases suddenly. This phenomenon will be the subject of further work in the coming year.

Collaborations outside the Blood Service give us access to world-leading multi-disciplinary expertise and broaden the reach of our research CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW

PROJECTS

Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

Product safety research projects, arranged by key research area, showing Blood Service researchers, All our collaborators are listed in Appendix 5.

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

ONGOING PROJECTS PS14-19 Evidence base risk of alloimmunisation as a result of transfusion of RhD negative Red Blood Cells (DEL and weak D)

TRANSFUSION TRANSMITTED INFECTIONS AND EMERGING RISKS

REDUCING THE RISK OF TRALI

REDUCING THE RISK ASSOCIATED WITH TRANSFUSION

A/Prof. Catherine Hyland, Dr Ellizna Schoeman, Eunike McGowan, Genghis Lopez, Glenda Millard, Prof. Robert Flower, A/Prof. Melinda Dean

COMPLETED PROJECTS

ONGOING PROJECTS

PS14-07 TRALI-Impact of leucodepletion on platelets

PS14-10 Using a sheep model to understand the effects of transfusion in severe trauma (CHORuS)

PS14-20 Clinical utility of genotyping in solving complex red cell serology: benefit in the contemporary Australian population demographic

PS16-07 Hepatitis E virus risk management: a study of 75,000 donations Dr Helen Faddy, Dr Veronica Hoad, Dr Clive Seed, Dr Mark Chan, Dr Tony Keller, Dr Zofia Perkowska-Guse, Sue Ismay, Prof. Robert Flower, Jesse Fryk, Thu Tran, Elise Hewlett, Dr Robert Harley, Philip Kiely

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 John-Paul Tung, Gabriela Simonova, Sanne Engkilde Pedersen, Arlanna Esguerra-Lallen, Elise Hewlett, Prof. Robert Flower PS14-08 Investigating antibody and non-antibody mediated TRALI using laboratory models Dr John-Paul Tung, A/Prof. Melinda Dean, Annette Sultana, Gabriela Simonova, Dr Monica Ng, Anne-Marie Christensen PS14-09 Investigating levels of biological response modifiers (BRMs) in donors implicated in clinical cases of TRALI Dr Lacey Johnson, A/Prof. Denese Marks, Dr Janet Wong

Dr Helen Faddy, Dr Clive Seed, Elise Hewlett, Prof. Robert Flower plus others as required

PS15-03 Modification of the ovine model to make it more robust

PS14-05 TTI Safety: Emerging risks — what can our existing data tell us?

Dr John-Paul Tung, Gabriela Simonova, Annette Sultana, Sanne Engkilde Pedersen, Arlanna Esguerra-Lallen, Elise Hewlett

Dr Helen Faddy, A/Prof. Melinda Dean, Dr Clive Seed, Dr Veronica Hoad, Dr Robert Harley, Prof. Robert Flower plus others as required PS15-01 Transfusion Transmitted Infections and Emerging Risks - Chikungunya and/or Zika virus emergence and establishment in Australia. Dr Helen Faddy, Prof. Robert Flower, Dr Elvina Viennet, plus others as required PS15-02 Is parvovirus B19 a concern for blood safety in Australia?

IMPROVING IDENTIFICATION OF BLOOD GROUPS BY GENOTYPING

Dr Helen Faddy, Prof. Robert Flower, Elise Gorman, Dr Tony Keller, Dr Chris Hogan, Dr Veronica Hoad, Dr Eileen Roulis PS16-01 Inactivation of Zika virus in plasma and in platelet concentrates following treatment with the THERAFLEX pathogen inactivation (PI) technologies Dr Helen Faddy, A/Prof. Denese Marks, Jesse Fryk

PS15-04 Developing laboratory models to help translate findings from the sheep model to theclinical setting Dr John-Paul Tung, A/Prof. Melinda Dean, Gabriela Simonova, Elise Hewlett

Dr John-Paul Tung, Gabriela Simonova, Sanne Engkilde Pedersen, Arlanna Esguerra-Lallen, Elise Hewlett PS14-11 Using a sheep model to investigate transfusion of patients with septic shock. (RESUS) Dr John-Paul Tung, Gabriela Simonova, Annette Sultana, Sanne Engkilde Pedersen, Arlanna Esguerra-Lallen PS16-02 Red cell storage duration and procoagulant effects: Role of microparticles and smaller particles Dr John-Paul Tung, A/Prof. Melinda Dean, Dr Lacey Johnson, Prof. Robert Flower, Gabriela Simonova, Marie-Anne Balanant, Emily McDonald, Amelie Babinet

UNDERSTANDING THE PATHOGENESIS OF ADVERSE TRANSFUSION REACTIONS-ROLE OF THE IMMUNE SYSTEM

OPTIMISING TRANSFUSION SUPPORT FOR NEONATES AT RISK OF HAEMOLYTIC DISEASE OF THE NEWBORN

ONGOING PROJECTS

COMPLETED PROJECTS

PS14-12 Impact of transfusion on dendritic cell function

PS14-16 Reduction in anti-D immunoglobulin usage by genotyping: a cost (and) benefit analysis

Katrina Ki, A/Prof. Melinda Dean, Dr Helen Faddy, Dr Lacey Johnson, Fenny Chong PS14-13 Transfusion associated immunomodulation in a cohort of cardiac patients – translating laboratory findings to a clinical context Alexis Perros, A/Prof. Melinda Dean, Kelly Rooks, Fenny Chong, Sanne Pederson, Arlanna Esguerra-Lallen, Dr John-Paul Tung, Dr Helen Faddy PS16-03 Do inflammasomes play a role in transfusion related immune modulation? Kelly Rooks, A/Prof. Melinda Dean

PS15-05 Understanding how white blood cells contribute to TRALI: The role of Extracellular DNA traps

PS16-04 Immune cell memory in transfusion outcomes – role of DNA methylation

A/Prof. Melinda Dean, Dr John-Paul Tung, Annette Sultana, Dr Zofia Perkowska-Guse

Fenny Chong, Kelly Rooks, A/Prof. Melinda Dean PS16-05 Determine the clinical significance of Red Cell Antibodies: Phase 1 A/Prof. Melinda Dean, Prof Robert Flower, A/Prof. Catherine Hyland, Dr John-Paul Tung, Emily Booked (maternity leave), Ji Yu (PhD student), Tanya Powley

A/Prof. Catherine Hyland, Glenda Millard, Helen O’Brien, Eunike McGowan, Prof. Robert Flower, Dr Chris Hogan

ONGOING PROJECTS 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, Glenda Millard, Helen O’Brien, Eunike McGowan, Prof. Robert Flower, Dr Chris Hogan PS16-06 The impact of high body mass index on strategies for managing routine antenatal anti-D prophylaxis programs in RhD negative obstetric cohorts A/Prof. Catherine Hyland, Dr Elizna Schoeman, Glenda Millard, Helen O’Brien, Genghis Lopez, Eunike McGowan, Prof. Robert Flower, Tanya Powley, Dr Chris Hogan

A/Prof. Catherine Hyland, Dr Elizna Schoeman, Glenda Millard, Helen O’Brien, Genghis Lopez, Eunike McGowan, Prof. Robert Flower, Tanya Powley, Dr Chris Hogan 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 RED BLOOD CELL STRUCTURE AND FUNCTION COMPLETED PROJECTS PS14-22 Cellular processes that regulate the lifespan of red blood cells A/Prof. Melinda Dean, Kelly Rooks, Prof. David Irving, Prof. Robert Flower

ONGOING PROJECTS PS15-07 Points of structural failure that may lead to storage-related changes of red cells Prof. Robert Flower, Dr Helen Faddy, Marie-Anne Balanant PS16-08 Novel red blood cell targets for biopharmaceuticals A/Prof. Melinda Dean, Prof. Robert Flower, Prof. David Irving, Fenny Chong, Katelyn Richards (PhD Student)

CONTENTS

THE YEAR IN REVIEW

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

unknown, which places a disproportionate demand on this limited resource.

Frozen blood components, particularly platelets, hold the promise of extended shelf life. For platelets, this promise is combined with potentially improved ability to stop bleeding in patients.

The FEISTY trial is a pilot study to demonstrate faster streamlined treatment using fibrinogen concentrate in place of cryoprecipitate, and to guide the design of a larger trial to demonstrate superior patient outcomes using guided fibrinogen dosing in trauma. Increased use of fibrinogen concentrate in Australia may improve patient outcomes, and ease demand for group AB cryoprecipitate at the Blood Service.

To extend our knowledge in this area, the Blood Service is participating in a clinical trial of frozen platelets (the CLIP trial) in collaboration with researchers from the University of Queensland.

Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

CLINICAL TRIALS OF NOVEL PRODUCTS

PRODUCT USAGE Research within the Product Usage research theme provides data to support effective transfusion outcomes, identify the most effective products for various clinical settings and understand how highdemand products are used. Collaborations with clinicians, hospitals and policy makers ensure this research is relevant to current practice and will influence outcomes both for patients and the blood sector as a whole. Research in this theme is divided into key research areas: •

Optimising product usage

•

Clinical trials of novel products

•

Clinical trials of conventional products

•

Data linkage

OPTIMISING PRODUCT USAGE Despite a decreasing demand for red cells in Australian and overseas, the demand for O (D) negative red cells continues to increase. Last year we reported the results of a study tracking the usage of O (D) negative red cells within the hospital system. The results of this study have been disseminated this year, preparing the way for change in the usage of this resource. The results were published in the prominent journal Transfusion, communicated to customers via Blood Service in Brief, and presented to key stakeholders at

the Strategic Blood Forum. A list of recommendations have been presented to the jurisdictional blood committee for consideration. More detail on jurisdictional difference in O (D) negative blood usage will be published soon, to allow more informed strategies to be identified to potentially reduce O (D) negative red blood cell usage. Based on the success of this work, a medical registrar project was performed to analyse the use of CMV-negative blood components at three tertiary NSW based centres. The results from this work were highly valued by the blood sector and it was presented at the quality assurance session of the Royal College of Pathologists conference in February 2017. This resulted in the registrar (Ibrahim Tohidi-Esfahani) obtaining the RCPA Quality Assurance Programs Oral Prize. Extending the results of a previous study on microchimerism, a study to examine whether there is a genetic basis for this phenomenon has commenced. This work is a collaboration between the Blood Service and a world class genomics facility (the Kinghorn Cancer Centre for Genomics).

The study compares the feasibility and clinical effectiveness of frozen platelets with fresh, liquid-stored platelets in patients that are undergoing cardiac surgery. To date, 80 patients have been randomised and 34 have been transfused, with no treatment related adverse events. Recruitment is expected to be complete by the end of 2017. Outcomes from this trial will provide data to support the possible use of frozen platelets in non-military hospitals.

CLINICAL TRIALS OF CONVENTIONAL PRODUCTS So far there is conflicting evidence regarding the effect of red cell storage on outcomes for patients, with systematic reviews unable to reach a definitive answer to whether or not ‘fresh is best’ in a blood transfusion setting. To answer this question, the Blood Service is a partner in a landmark study to examine the effect of age of blood transfused on patient outcomes. The study, known as TRANSFUSE is a prospective, randomised controlled study funded by the NHMRC, and involving multiple centres around the world.

The Blood Service is collaborating with Gold Coast University Hospital to trial the use of fibrinogen concentrate as a replacement for cryoprecipitate (known as the FEISTY) trial. A detailed discussion of the study design and protocol, was published this year, and the lead site commenced recruitment in December 2016. Recruitment is currently ahead of schedule, with 60 of 100 patients randomised to the study at the end of June 2017.

DATA LINKAGE Projects within this area aim to improve policy and practice through analysing existing data related to blood usage and patient outcomes. Of particular note, this work includes a collaboration between the Blood Service, the Kolling Institute and NSW Kids and Families to improve the treatment of mothers who bleed during childbirth. By understanding how blood is used in these situations, and the outcomes of those transfusions, we can inform guidelines for clinical practice. The inclusion of NSW Health as a stakeholder in this collaboration is expected to facilitate the timely implementation of any findings into the health system.

Recruitment of the 5000 patients has concluded, and analysis of data is underway. Fibrinogen concentrate is licensed in Australia for treatment of congenital hypofibrinogenaemia, but is being increasingly used off-label for urgent treatment of trauma associated coagulopathy and bleeding, for which cryoprecipitate is indicated. There are a number of clinical advantages of fibrinogen concentrate over cryoprecipitate, including simplified product storage and administration, reduced time to treat, and no need to ABO match. In emergency situations, AB cryoprecipitate is used generically if the patient ABO group is

Collaborations with clinicians, hospitals and policy makers ensure this research will influence outcomes for patients and the blood sector

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

UNDERSTANDING DEMAND BRINGS AWARD FOR RESEARCHER

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

PROJECTS OPTIMISING PRODUCT USAGE

CLINICAL TRIALS OF NOVEL PRODUCTS

CLINICAL TRIALS OF CONVENTIONAL PRODUCTS

COMPLETED PROJECTS

ONGOING PROJECTS

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

PU14-03 Clip Trial - Cryopreserved versus Liquid Stored Platelets for surgical bleeding

Dr Rena Hirani, Prof. David Irving, Dr Joanne Pink, Perfecto Diaz, Dr Peta Dennington, Dr Janet Wong, Sam Price

A/Prof Denese Marks, Dr Lacey Johnson, Prof. David Irving

PU14-06 TRANSFUSE - Standard Issue Transfusion versus fresher red blood cell use in intensive care- a randomised controlled trial

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 PU16-01 Genotype analysis of transfused Australian trauma patients

PU16-02 The incidence of microchimerism in chronically transfused patients

DATA LINKAGE ONGOING PROJECTS

Dr Rena Hirani, Prof. David Irving

Ibrahim Tohidi-Esfahani, a medical registrar working within the Blood Service, received an award from the Royal College of Pathologists for his study on the use of CMV negative blood components.

Product Usage projects arranged by key research area, showing Blood Service researchers. All our collaborators are listed in Appendix 5.

Dr Rena Hirani, Prof. David Irving, Shaba Vakalia (PhD candidate) PU16-04 The incidence of microchimerism in paediatric patients Dr Rena Hirani, Prof. David Irving

PU14-04 An open label, single arm clinical trial assessing the safety and efficacy of allogeneic 20 per cent serum eye drops in severe dry eye patients A/Prof. Denese Marks, Dr Peta Dennington, Dr Barbara Bell, Dr Joanne Tan, Prof. David Irving

Prof. David Irving, 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 A/Prof. Melinda Dean, Prof. Robert Flower, Dr Chris Hogan, Shauna French, Prof. David Irving PU16-03 An alternative to cryoprecipitate Dr Phillip Mondy, Dr Wayne Dyer

PU14-08 Exploring the impact of blood transfusion on maternity outcomes and healthcare utilisation 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) PU14-10 Massive Transfusion registry Prof. David Irving, Prof. Robert Flower, Dr Chris Hogan (TORC II Steering Committee members)

Ibrahim’s project, which was supervised by Dr Rena Hirani, explored the use of CMV negative blood products within a hospital setting. More than 70 per cent of the Australian population is affected by CMV by adulthood, and most will not even realise,” explains Dr Hirani, but CMV can be dangerous to some patients, especially pregnant mothers and their unborn babies. We need to understand how our limited CMV negative components are being used to help us plan to meet future demand.” Ibrahim found that more than 80 per cent of CMV negative products aren’t used for patients who need them most, and recommends changes to practice to allow us to meet future demand. His talk was presented at the Royal College of Pathologists conference, which was held from 24-26 February 2017, and received the DS Nelson and RCPA Quality Assurance Programs Oral Presentations award. The award is presented in recognition of work which highlights the use of QA/QC data to improve quality processes or outcomes in laboratories.

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW

PUBLICATIONS AND INVITED PRESENTATIONS

Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDICES

APPENDIX 1

Marks DC, van der Meer PF, Biomedical Excellence for Safer Transfusion (BEST) collabortaive Serum eye drops: a survey of international production methods. Vox Sanguinis 2017,112:310-317.

Publications which have been epublished ahead of print during the reporting period, 1 July 2016-

Pasricha SR, Marks DC, Salvin H, Brama T, Keller AJ, Pink J, Speedy J. Postdonation iron replacement for maintaining iron stores in female whole blood donors in routine donor practice: results of two feasibility studies in Australia. Transfusion. 2017 doi: 10.1111/trf.14173. Epub 2017 May 18.

30 June 2017 are indicated in italics. These items will also appear in print in the following reporting period. Blood Service authors are shown in bold.

Gemelli CN, Hayman J, Waller D. Frequent whole blood donors: understanding this population and predictors of lapse. Transfusion 2017,57:108-114. Masser BM, Davison TE, Chapman CM. How can we encourage our voluntary non-remunerated donors to donate more frequently? ISBT Science Series 2016:112-118 Masser BM, France CR, Himawan LK, Hyde MK, Smith G. The impact of the context and recruitment materials on nondonors’ willingness to donate blood. Transfusion 2016,56:2995-3003. Moloney G, Hayman J, Gamble M, Smith G, Hall R. Translation strategies, contradiction, and the theory of social representations: Why discussing needles may improve blood donor retention. Br J Soc Psychol 2017,56:393-415. Waller D, Mondy P, Brama T, Fisher J, King A, Malkov K, Wall-Smith D, Ryan L, Irving DO. Determining the effect of vein visualization technology on donation success, vasovagal symptoms, anxiety and intention to re-donate in whole blood donors aged 18-30 years: A randomized controlled trial. Vox Sanguinis 2016,111:135-143.

DONOR HEALTH AND WELLBEING Goldman M, Magnussen K, Gorlin J, Lozano M, Speedy J, Keller A, Pink J, et al. International Forum regarding practices related to donor haemoglobin and iron. Vox Sanguinis 2016,111:449-455. Quinn B, Seed C, Keller A, Maher L, Wilson D, Farrell M, Caris S, Williams, J, Madden A, Thomson A, Pink J and Hellard ME. Reexamining blood donor deferral criteria relating to injecting drug use. International Journal of Drug Policy 2017,48:9-17.

PRODUCT DEVELOPMENT AND STORAGE Acker JP, Marks DC, Sheffield WP. Quality Assessment of Established and Emerging Blood Components for Transfusion. J Blood Transfus 2016,2016:4860284.

Loh YS, Tan S, Kwok M, Stark MJ, Marks DC. Reduction of biological response modifiers in the supernatant of washed paediatric red blood cells. Vox Sanguinis 2016,111:365-373.

PEER REVIEWED PUBLICATIONS

DONOR BEHAVIOUR

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; 56: 1807-1818.

Germain M, Gregoire Y, Vassallo RR, Acker JP, Cardigan R, de Korte D, Irving DO, Bégué S, Biomedical Excellence for Safer Transfusions (BEST) collaborative Quality control of apheresis platelets: a multicentre study to evaluate factors that can influence pH measurement. Vox Sanguinis 2017.

Schoenwaelder SM, Darbousset R, Cranmer SL, Ramshaw HS, Orive SL, Sturgeon S, Yuan Y, Yao Y, Krycer JR, Woodcock J, Maclean J, Pitson S, Zheng Z, Henstridge DC, van der Wal D, Gardiner EE, Berndt MC, Andrews RK, James DE, Lopez AF, Jackson SP. 14-3-3ζ regulates the mitochondrial respiratory reserve linked to platelet phosphatidylserine exposure and procoagulant function. Nat Commun. 2016 Sep 27;7:12862. So-Osman C, van der Wal DE, Allard S on behalf of the ISBT Working Party Clinical Transfusion. Patient Blood Management initiatives on a global level - The results of an International Society of Blood Transfusion Survey. ISBT Science Series 2017, 0, 1-9. Wood B, Padula MP, Marks DC, Johnson L. Refrigerated storage of platelets initiates changes in platelet surface marker expression and localization of intracellular proteins. Transfusion 2016,56:2548-2559.

PRODUCT SAFETY Aung HH, Tung JP, Dean MM, Flower RL, Pecheniuk NM. Procoagulant role of microparticles in routine storage of packed red blood cells: potential risk for prothrombotic post-transfusion complications. Pathology 2017,49:62-69. Barns S, Sauret E, Saha SC, Flower R, Gu Y. Two-Layer Red Blood Cell Membrane Model Using the Discrete Element Meth. Applied Mechanics and Materials 2016,846:270-275. Byrne L, Obonyo NG, Diab S, Dunster K, Passmore M, Boon AC, Hoe LS, Hay K, Van Haren F, Tung JP, Cullen L, Shekar K, Maitland K, Fraser JF An Ovine Model of Hyperdynamic Endotoxemia and Vital Organ Metabolism. Shock 2017 doi: 10.1097/ SHK.0000000000000904. [Epub ahead of print]. Hoad VC, Gibbs T, Ravikumara M, Nash M, Levy A, Tracy SL, Mews C, Perkowska-Guse Z, Faddy HM and Bowden S. First confirmed case of transfusion-transmitted hepatitis E in Australia. Medical Journal of Australia 2017,206:289-290. Ji Y, Flower R, Hyland C, Saiepour N, Faddy HM. Genetic factors associated with iron storage in Australian blood donors. Blood Transfusion 2016 Dec 20:1-7. doi: 10.2450/2016.0138-16 Ki K, Flower RL, Faddy HM, Dean MM. Platelet concentrates modulate myeloid dendritic cell immune responses. Platelets. 2017 May 15:1-10. doi: 10.1080/09537104.2017.1306045. [Epub ahead of print] Lopez GH, McGowan EC, McGrath KA, Abaca-Cleopas ME, Schoeman EM, Millard GM, O’Brien H, Liew YW, FLower RF, Hyland CA A D+ blood donor with a novel RHD*D-CE(5-6)-D gene variant exhibits the low-frequency antigen RH23 (DW ) characteristic of the partial DVa phenotype. Transfusion 2016 56:2322-30 Lopez GH, Wilson B, Liew YW, Kupatawintu P, Emthip M, Hyland CA, Flower RL. An alloantibody in a homozygous GYP*Mur individual defines JENU (MNS49), a new high-frequency antigen on glycophorin B. Transfusion 2017,57:716-717. McGowan EC, Lopez GH, Knauth CM, Liew YW, Condon JA, Ramadi L, Parsons K, Turner EM, Flower RL, Hyland CA Diverse and novel RHD variants in Australian blood donors with a weak D phenotype: implication for transfusion management. Vox Sanguinis

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

2017,112:279-287. Nayanajith PGH, Saha SC, Sauret E, Flower RL, Y-T Gu (2016) A coupled SPH-DEM approach to model the interactions between multiple red blood cells in motion in capillaries Int J Mech Mater Des 12: 477-494. doi:10.1007/s10999-015-9328-8 Passmore MR, Fung YL, Simonova G, Foley SR, Dunster KR, Diab SD, Tung JP, Minchinton RM, McDonald CI, Anstey CM, Shekar K and Fraser JF Inflammation and lung injury in an ovine model of extracorporeal membrane oxygenation support. Am J Physiol Lung Cell Mol Physiol 2016,311:L1202-L1212.

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDIX 1

Polwaththe G, Hasitha N, Saha SC, Sauret E, Flower R, Senadeera, W, Gu, YT (2016) SPH-DEM approach to numerically simulate the deformation of three-dimensional RBCs in non-uniform capillaries. BioMed Eng OnLine 15(Suppl 2):161 page 349 to 370 DOI: 10.1186/ s12938-016-0256-0 Quantock KM, Lopez GH, Hyland CA, Liew YW, Flower RL, Niemann FJ, Joyce A. Anti-D in a mother, hemizygous for the variant RHD*DNB gene, associated with hemolytic disease of the fetus and newborn. Transfusion 2017 DOI:10.1111/trf.14156. Schoeman EM, Lopez GH, McGowan EC, Millard GM, Oâ&#x20AC;&#x2122;Brien H, Roulis EV, Liew YW, Martin JR, McGrath KA, Powley T, FLower RL, Hyland CA Evaluation of targeted exome sequencing for 28 protein-based blood group systems, including the homologous gene systems, for blood group genotyping. Transfusion 2017,57:1078-1088. Shrestha AC, Flower RL, Seed CR, Stramer SL, Faddy HM. A Comparative Study of Assay Performance of Commercial Hepatitis E Virus Enzyme-Linked Immunosorbent Assay Kits in Australian Blood Donor Samples. J Blood Transfus 2016,2016:9647675. Shrestha AC, Flower RL, Seed CR, Rajkarnikar M, Shrestha SK, Thapa U, Hoad VC and Faddy HM Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal. BMC Infectious Diseases 2016,16:707. Shrestha AC, Flower RLP, Seed CR, Keller AJ, Harley R, Chan H-T, Hoad VC, Warrilow D, Northill J, Holmberg J, Faddy HM. Hepatitis E virus RNA in Australian blood donations. Transfusion 2016,56:3086-3093. Shrestha AC, Flower RL, Seed CR, Keller AJ, Hoad V, Harley R, Leader R, Polkinghorne B, Furlong C and Faddy HM. Hepatitis E virus infections in travellers: assessing the threat to the Australian blood supply. Blood Transfus 2016:1-8. J. R. Storry, L. Castilho, Q. Chen, G. Daniels, G. Denomme, W. A. Flegel, C. Gassner, M. de Haas, C. Hyland, M. Keller, C. LomasFrancis, J. M. Moulds, N. Nogues, M. L. Olsson, T. Peyrard, C. E. van der Schoot, Y. Tani, N. Thornton, F. Wagner, S. Wendel, C. Westhoff and V. Yahalom International society of blood transfusion working party on red cell immunogenetics and terminology: report of the Seoul and London meetings. ISBT Science Series 2016,11:118-122.

Williams CR, Mincham G, Faddy H, Viennet E, Ritchie SA, Harley D. Projections of increased and decreased dengue incidence under climate change. Epidemiology and Infection 2016,144:3091-3100.

PRODUCT USAGE Crighton GL, Scarborough R, McQuilten ZK, Phillips LE, Savoia HF, Williams B, et al. Contemporary management of neonatal alloimmune thrombocytopenia: good outcomes in the intravenous immunoglobulin era: results from the Australian neonatal alloimmune thrombocytopenia registry. J Matern Fetal Neonatal Med 2016:1-7. Crighton G, Wood E, Scarborough R, Ho PJ, Bowden D. Haemoglobin disorders in Australia: where are we now and where will we be in the future? Internal Medicine Journal 2016,46:770-779. Dyer WB, Tan JCG, Day T, Kiers L, Kiernan MC, Yiannikas C, et al. Immunomodulation of inflammatory leukocyte markers during intravenous immunoglobulin treatment associated with clinical efficacy in chronic inflammatory demyelinating polyradiculoneuropathy. Brain and Behavior 2016,6:e00516 Fedele PL, Polizzotto MN, Grigoriadis G, Waters N, Comande M, Borosak M, Portbury D and Wood E. Profiling clinical platelet and plasma use to inform blood supply and contingency planning: PUPPY, the prospective utilization of platelets and plasma study. Transfusion 2016,56:2455-2465. Hirani R, Wong J, Diaz P, Mondy P, Hogan C, Dennington PM, Pink J and Irving DO. A national review of the clinical use of group O D- red blood cell units. Transfusion 2017 15:1254-1261 McQuilten ZK, Zatta AJ, Andrianopoulos N, Aoki N, Stevenson L, Badami KG, et al. Evaluation of clinical coding data to determine causes of critical bleeding in patients receiving massive transfusion: a bi-national, multicentre, cross-sectional study. Transfus Med 2017 Apr;27(2):114-121. Winearls J, Wullschleger M, Wake E, Hurn C, Furyk J, Ryan G, Dyer W, et al. Fibrinogen Early In Severe Trauma studY (FEISTY): study protocol for a randomised controlled trial. Trials 2017,18:241. Winearls J, Campbell D, Hurn C, Furyk J, Ryan G, Trout M, Dyer W, et al. Fibrinogen in traumatic haemorrhage: A narrative review. Injury 2017,48:230-242.

INTERDISCIPLINARY COLLABORATIONS Faddy HM, Fryk JJ, Watterson D, Young PR, Modhiran N, Muller DA, Keil SD, Goodrich RP and Marks DC Riboflavin and ultraviolet light: impact on dengue virus infectivity. Vox Sanguinis 2016,111:235-241.

Swaminathan A, Viennet E, McMichael AJ, Harley D. Climate change and the geographical distribution of infectious diseases. In: Infectious Diseases: John Wiley & Sons, Ltd; 2017. pp. 470-480.

Fryk JJ, Marks DC, Hobson-Peters J, Prow NA, Watterson D, Hall RA, Young PR, Reichenberg S, Sumian C and Faddy H. Dengue and chikungunya viruses in plasma are effectively inactivated after treatment with methylene blue and visible light. Transfusion 2016,56:2278-2285.

Viennet E, Mincham G, Frentiu FD, Jansen C, Montgomery BL, Harley D, Flower RL, Williams CR, Faddy HM Epidemic Potential for Local Transmission of Zika Virus in 2015 and 2016 in Queensland, Australia. In: PLOS Current Outbreaks. 2016/12/13 ed; 2016.

Rooks K, Seed CR, Fryk JJ, Hyland CA, Harley RJ, Holmberg JA, Marks DC, Flower RL, Faddy HM. Mitigating the Risk of TransfusionTransmitted Dengue in Australia. Journal of Blood Transfusion 2016; 2016:3059848. Epub 2016 Nov 13.

Viennet E, Ritchie SA, Williams CR, Faddy HM, Harley D. Public Health Responses to and Challenges for the Control of Dengue Transmission in High-Income Countries: Four Case Studies. PLoS Negl Trop Dis 2016,10:e0004943.

Hoad V, Bentley P, Bell B, Pathak P, Chan HT, Keller A. The infectious disease blood safety risk of Australian hemochromatosis donations. Transfusion 2016,56:2934-2940.

Wei L, Shan ZG, Flower RL, Wang Z, Wen JZ, Luo GP, et al. The distribution of MNS hybrid glycophorins with Mur antigen expression in Chinese donors including identification of a novel GYP.Bun allele. Vox Sanguinis 2016,111:308-314.

Connolly AR, Hirani R, Ellis AV, Trau M. A DNA Circuit for IsomiR Detection. ChemBioChem 2016,17:2172-2178.

Wei L, Lopez GH, Ji Y, Condon JA, Irwin DL, Luo G, Hyland CA and Flower RL. Genotyping for Glycophorin GYP(B-A-B) Hybrid Genes Using a Single Nucleotide Polymorphism-Based Algorithm by Matrix-Assisted Laser Desorption/Ionisation, Time-of-Flight Mass Spectrometry. Molecular Biotechnology 2016,58:665-671.

Walton DC, Hiho SJ, Cantwell LS, Diviney MB, Wright ST, Snell GI, et al. HLA Matching at the Eplet Level Protects Against Chronic Lung Allograft Dysfunction. Am J Transplant 2016,16:2695-2703. Lim KH, Booth AO, Nowson CA, Szymlek-Gay EA, Irving DO, Riddell LJ. Hepcidin is a Better Predictor of Iron Stores in Premenopausal Women than Blood Loss or Dietary Intake. Nutrients 2016,8. 49

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

APPENDIX 1 PEER REVIEWED PUBLISHED ABSTRACTS DONOR BEHAVIOUR

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDICES

Carver A, Chell K, Davison TE, Masser B. Understanding motivators for blood donation among men: A review of the evidence. Vox Sanguinis 2016; 111 (S1), 122.

PRODUCT SAFETY

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59

Hyland RA, Cha Y, Marks DC. Adapting lean methodology to improve workflow in a research and development laboratory. Transfusion 2016; 56 (Suppl S4): 3A-262A.

PRODUCT DEVELOPMENT AND STORAGE Davis AM, Johnson L, Veale MF, Raynel S, Hyland RA, Marks DC. Microparticles contribute to the adhesion of cryopreserved platelets to collagen under shear stress. Transfusion 2016; 56 (Suppl S4): 3A-262A

Hyland R, Wood B, L Johnson L, Marks D. Maximising platelet usage by delaying refrigerated storage. Vox Sanguinis 2017; 112 (suppl. S1); 5-295. Johnson L, Choi C, Marks DC. Coagulation factor binding to platelets and microparticles: potential mediators of the procoagulant activity of cryopreserved platelets. Transfusion 2016; 56 (Suppl S4): 3A-262A Johnson L, Jenkins E, Wood BW, Marks DC. Lectin mapping reveals differences in glycosylation patterns on platelet proteins following cryopreservation and cold storage. Transfusion 2016; 56 (Suppl S4): 3A-262A Johnson L, Tan S, Hyland RA, Noorman F, JBadloe JF, Dumont LJ, Marks DC. An interlaboratory comparison of cryopreserved platelet quality. Transfusion 2016; 56 (Suppl S4): 3A-262A Marks DC, van der Meer PF, Best Collaborative. Serum eye drops: a survey of international production methods. Transfusion 2016; 56 (Suppl S4): 3A-262A Loh Y, Costa M, Lu Z, Marks DC. Characterization of platelet lysate produced from expired platelet components: suitability for expansion of mesenchymal stromal cells. Transfusion 2016; 56 (Suppl S4): 3A-262A

Winter KM, Webb RG, Johnson L, Marks DC. A comparison of additive solutions (SAG-M, AS-3 & ESOL-5) for storage of thawed deglycerolised red cells. Vox Sanguinis 2016; 111 (Suppl. S1): 1-322

Gemelli CN, Thijsen A, Wright ST, Davison TE. Examining trends in first-time plasmapheresis donors’ return behaviour: Why do some donors only donate once? Vox Sanguinis 2016; 111(S1)

Thijsen A, Davison TE, Bell B, Fisher J, O’Donovan J, Bramble C, Del Aguila C, Masser B A randomised trial to facilitate donor compliance with strategies to prevent vasovagal reactions: comparison of web-based and in-centre approaches. Vox Sanguinis 2016 Sep; 111(Issue Supplement S1): 48.

Appendix 5 - Collaborations 70

Waters L, Padula M, Marks D, Johnson L. Cryopreserved platelets demonstrate a reduced response to collagen stimulation. Vox Sanguinis 2017; 112 (suppl. S1); 5-295.

Winter KM, Hyland RA, Tan S, Webb RG, Davis A, Dennington PM, Marks DC. Extending the post-thaw shelf-life of cryoprecipitate. Vox S Wood BW, Padula M, Marks DC, Johnson L. Characterization and comparison of the surface phenotype of refrigerated and cryopreserved platelets. Transfusion 2016; 56 (Suppl S4): 3A-262A anguinis 2016; 111 (Suppl. S1): 1-322

DONOR HEALTH AND WELLBEING

Appendix 4 - Student projects 66

van der Wal DE, Davis AM, Mach M, Marks DC. The role of neuraminidases in platelet function. Research and Practice in Thrombosis and Haemostasis 2017; 1 (Suppl S1): 1-15.

Davison TE, Masser B, Chapman C. How can we encourage our voluntary non-remunerated donors to donate more frequency? Vox Sanguinis 2016; 111(S1),

Appendix 3 - Abstracts accepted for oral or poster presentations 60

subsets in cold-stored and cryopreserved platelets using a novel cell death marker. Vox Sanguinis 2017; 112 (suppl. S1); 5-295.

Loh Y, Su Y, Costa M, Marks D. Production and quality of allogeneic platelet gel produced by precipitation of expired apheresis platelet concentrates. Vox Sanguinis 2017; 112 (suppl. S1); 5-295. Tan JC, Webb RG, Marks DC. Serum growth factor and fibronectin concentrations in dry eye patients and healthy blood donors. Transfusion 2016; 56 (Suppl S4): 3A-262A Tohidi-Esfahani I, Tan S, Johnson L, Chen V, Marks DC. Identification of procoagulant platelet

Balanant M, Kashchuk A, Stilgoe A, Flower R, Rubinsztein-Dunlop H, Sauret E, Saha S, Gu Y(2017) Measurement of Mechanical Properties of Red Blood Cells Post-Storage Using Optical Tweezers Vox Sanguinis 112 (S 1), 37 Barns S, Sauret E, Flower R, Gu Y. (2017) Numerical Investigation of Red Blood Cell Membrane Mechanical Properties and Deformability During Indentation, Vox Sanguinis 112 (S 1), 139 Dean MM, Rooks KM, Chong FN, Faddy HM, Tung JP, Flower RL. Do donor and/or processing-related differences impact on blood product quality? Vox Sanguinis, Volume 111 (Suppl. 1) page 70, November 2016. Dean MM, Ki K, Henry S, Faddy HM, Flower RL. Mechanisms underpinning transfusion related immune modulation: erythrophagocytosis and immune modulation in different myeloid cell subsets. Vox Sanguinis, Volume 111 (Suppl. 1) page 266, November 2016. Faddy HM, Tran T, Hewlett E, Seed CR, Hoad V, Chan HT, Harley R, Keller A, Hall RA, Prow N, Bielefeldt-Ohmann H, Flower RLP. Ross River virus in ‘at-risk’ Australian blood donors: implications for blood supply safety. Vox Sanguinis, Volume 111 (Suppl. 1) page 75, November 2016. Faddy HM, Tran T, Seed C, Chesneau S, Ismay S, Hogan C, Flower R. Cytomegalovirus-seronegative component supply and demand: are we able to meet our future needs? Vox Sanguinis, Volume 111 (Suppl. 1) page 49, November 2016. RL Flower , EM Schoeman, Y-W Liew, JA Condon, T Powley, GH Lopez, C Hogan and CA Hyland (2016) Massively parallel sequencing in complex blood group investigations: Resolving the previously unresolvable. Pathology 48, S98 Fryk JJ, Hoad VC, Flower RLP, Seed CR, Perkowska Z, Hogema B, Tran TV, Hewlett E, Faddy HM. Prevalence of hepatitis e virus in Australian whole-blood donors during 2016. Pathology 49, S114-S115, 2017. Gorman EC, Flower RLP, Hoad VC, Frentiu FD, Faddy HM. Seroprevalence of antibodies to primate erythroparvovirus 1 among Australian blood donors. Pathology 49, S115-S116, 2017. Hyland CA, Millard GM, McGowan EC, O’Brien H, Lopez GH, Schoeman EM, Flower RL. African and Asian RHD blood group genotypes as a complication of non-invasive prenatal testing (NIPT). 34th International Congress of the ISBT, Dubai, United Arab Emirates 03-08 September 2016. Vox Sanguinis 2016 Sept; 111(Supl 1) 56-57. (Oral) Hyland CA, Schoeman EM, Powley T, Wilson B, Martin JR, Liew YW, Lopez GH, Millard GM, McGowan EC, O’Brien H, Flower RL. Evaluation of targeted exome sequencing for 28 blood group systems, including homologous gene systems, for comprehensive blood group genotyping. 34th International Congress of the ISBT, Dubai, United Arab Emirates 03-08 September Vox Sanguinis 2016 Sept; 111(Supl 1) 42. (Oral) Hyland CA, Gardener GJ, Baidya S, O’Brien H, Millard GM, McGowan EC, Lopez GH, Schoeman EM, Liew YW, Flower RL. A case of

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDIX 1 suspected confined placental chimerism following detection of fetal RHD signals in maternal plasma discordant with the newborn serology. 34th International Congress of the ISBT, Dubai, United Arab Emirates 03-08 September 2016. Vox Sanguinis 2016 Sept; 111(Supl 1) 245. (Poster)

Marks DC, Fryk JJ, Hobson-Peters J, Watterson D, Hall RA, Young PR, Reichenberg S, Tolksdorf F, Sumian C, Gravemann U, Seltsam A, Faddy HM Zika virus infectivity is reduced following treatment with the THERAFLEX UVC-Platelet and THERAFLEX MB-Plasma systems Vox sanguinis Volume 112 (Suppl 1) 152 June 2017

Perros AJ, Esguerra-Lallen A, Rooks K, Chong FN, Flower RL, Engkilde-Pedersen S, Naidoo R, Tung JP, Fraser J, Tesar P, Ziegenfuss M, Smith S, Oâ&#x20AC;&#x2122;Brien D, Dean MM. Modulation of immune responses in patients following cardiac surgery. Pathology 49, S109, 2017.

INVITED PUBLICATIONS

Perros AJ, Flower RL, Christensen AM, Dean MM. Transfusion-related immunomodulation: Importance of cell-to-cell interactions in studying underlying mechanisms. European Journal of Immunology V46, S1, 2016 Roche E, Passmore MR, Simonova G, Diab SD, Dunster KR, Bierman W, Fraser JF, Tung JP. A Histologic Approach to Qualify Lung Tissue Damage in a Sheep Model of Transfusion-Related Lung Injury: Role of Red Blood Cell Storage Duration and Heat Treatment. American Journal of Clinical Pathology. 146(S1), 49. doi: 10.1093/ajcp/aqw161.049. Epub 2016 Sep 9 Roulis EV, Schoeman EM, Nagaraj SH, Hyland CA, Flower RL. A number of novel blood group variants discovered from the Denisovan human sequencing project. 27th Regional Congress of the ISBT, Copenhagen 17-21 June 2017 Vox Sanguinis 2017 June; 111(Supl 1) 42. (Oral) Schoeman EM, Hyland CA, Roulis EV, Nagaraj SH, Flower RL. Blood group variant call analysis from a 100-year-old lock of hair of an Indigenous Australian. 27th Regional Congress of the ISBT, Copenhagen 17-21 June 2017 Vox Sanguinis 2017 June; 111(Supl 1) 42. (Poster) Sultana A, Meka D, Dean MM, Simonova G, Christensen AM, Flower RL, Tung JP. The potential of inflammatory responses to contribute to the development of transfusion-related acute lung injury (TRALI). European Journal of Immunology V46, S1, 2016 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. European Journal of Immunology 2016 Aug;46:883-883. Tung JP, Simonova G, Diab S, Dunster K, Passmore M, Roche E, Bierman W, Meka D, Dean MM, Fraser J. Tung JP, A Preliminary Analysis of the Incidence of Transfusion-Related Acute Lung Injury (TRALI) in a Sheep Model Following Transfusion with the Supernatant from Leukodepleted Red Cell Units. Blood; 2016; 128:1462 Tung JP, Simonova G, Engkilde-Pedersen S, Esguerra-Lallen A, Sultana AJ, Hewlett E, Obonyo N, Millar J, Flower RL, Fraser JF. Pointof-care testing in an ovine model of transfusion-related acute lung injury (TRALI). Pathology. 2017, 49, S107-8. doi: 10.1016/j. pathol.2016.12.309 Ling Wei, Yanli Ji, Guangping Luo, Catherine Hyland, Robert Flower (2016) Hybrid glycophorins: Silent genetic variants complicate genetic testing. Pathology 48, S98

PRODUCT USAGE

DONOR BEHAVIOUR Masser BM, Davison TE, Chapman CM. How can we encourage our voluntary non-remunerated donors to donate more frequently? ISBT Science Series 2017; 12(1); 112-18.

PRODUCT DEVELOPMENT AND STORAGE Ramirez-Arcos S, Marks DC, Acker JP, Sheffield WP. Quality and Safety of Blood Products. Journal of Blood Transfusion. 2016; 2016:2482157. doi: 10.1155/2016/2482157. Epub 2016 Dec 29.18. (Editorial).

PRODUCT SAFETY Hyland CA, Roulis EV, Schoeman EM, Lopez GH, Flower RL. Routine application of genotyping a step closer: direct PCR on plasma. Editorial. Ann Blood. 2017;2:3

INVITED EXTERNAL PRESENTATIONS DONOR BEHAVIOUR Masser B, Davison T. Donor Research in Australia. Transfusion Update Conference 2017, April 27-28, Sydney Australia. van Dongen A, Williams LA, Masser B, Thijsen A, Davison T. The emotional psychology of blood donors: A time-course approach. Invited address at the 27th Regional Congress of the International Society of Blood Transfusion (ISBT), June 2017, Copenhagen, Denmark Davison TE, Masser BM. How to recruit and maintain voluntary non-remunerated plasmapheresis donors. The 34th International Congress of the International Society of Blood Transfusion. 3-8 September 2016, Dubai, UAE. Masser BM, Davison TE, Chapman C. How can we encourage our voluntary non-remunerated donors to donate more frequently? The 34th International Congress of the International Society of Blood Transfusion. 3-8 September 2016, Dubai, UAE

DONOR HEALTH AND WELLBEING Pink J, G. Kotsiou G, Wright ST. Safe and Sustainable Plasmapheresis. 27th Regional Congress of the ISBT, 17-21 June 2017. Copenhagen, Denmark

Hirani R, Tohidi-Esfahani I, Diaz P, Langshaw M, Mondy P, Irving DO The fate of blood products derived from cytomegalovirusseronegative donors at 3 tertiary-referral hospitals: a pilot study. Pathology. 2017 49(S1):S62-S63

PRODUCT DEVELOPMENT AND STORAGE

CROSS-DISCIPLINARY COLLABORATIONS

Johnson L. BEST91: Resuspension of cryopreserved platelets in PAS. Biomedical Excellence for Safer Transfusion (BEST) LIII, Sydney, 28 April 2017(Oral)

Ki KK, Johnson L, Faddy HM, Flower RL, Marks DC, Dean MM. Exposure to cryopreserved platelets mediates suppression of myeloid dendritic cell subset immune responses. Pathology 49, S109, 2017.

Hyland RA. The CLIP Trial. NSW Blood User Group Meeting, Sydney Australia, 6 December 2016.

Fryk JJ, Marks DC, Hobson-Peters J, Watterson D, Hall RA, Young PR, Reichenberg S, Sumian C, Faddy HM. ZIKV virus in plasma is inactivated after treatment with methylene blue and light illumination. Pathology 49, S115, 2017.

Johnson L. Keeping platelets cool: cold storage and cryopreservation. Transfusion Update 2017, Sydney Australia, 27 April 2017 (Oral)

Marks DC. Pathogen Inactivation: Research at the Blood Service. Transfusion Update, Sydney Australia, April 2017

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

APPENDIX 1 Marks DC. Donor factors and blood processing methods that contribute to red cell haemolysis. Biomedical Excellence for Safer Transfusion Collaborative. Sydney Australia, April 2017. Marks DC. The CLIP Trial. Metropolitan Blood User Group Meeting, Sydney Australia, 29 November 2016.

PUBLIC DISSEMINATION DONOR BEHAVIOUR

RESEARCH PROGRAM 2016-2017

Marks DC. The effect of Theraflex on the infectivity of arboviruses. Macopharma Blood Safety Symposium, 27th Regional Congress of the ISBT, June 17–21, 2017, Copenhagen, Denmark.

Masser BM. First time donors: waiting for the roller coaster. Joint Blood Service and UQ Press Release. 14th June 2016 - https://www. uq.edu.au/news/article/2016/06/first-time-blood-donors-waiting-roller-coaster.

Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

PRODUCT SAFETY

Masser BM. 2GB Sydney Radio Interview on 12/6/16 - http://www.2gb.com/article/natalie-peters-barbara-masser-national-blood-donorweek

Faddy HM. Chagas disease and blood transfusion safety: An Australian perspective. International Congress for Tropical Medicine and Malaria, Brisbane, Australia September 19 2016. Faddy HM. Dengue fever in Australia: Clinical features, outbreaks & prevention. AACB AIMS 2016 Combined Scientific Meeting, Brisbane, Australia, September 15 2016. Faddy HM. Emerging transfusion-transmitted infections: looking for a needle in a haystack? ACEMS & Red Cross Blood Service Workshop, Sydney, Australia, August 16 2016. Flower RLP, Balanant MA, Dean MM, Sauret E, Sahab S, Gub YT ; Reversal of Storage-Related Morphological Changes in Red Blood Cells: What is the Impact in the Microcirculation. Invited Oral. 16th International Conference on Biomedical Engineering (ICBME 2016), Singapore; December 2016

Masser BM. Hope FM, 19/4/17 – Preparation tips for first time donors - http://hope1032.com.au/stories/culture/2017/hope-breakfastpodcast-laura-duncan-21-april-2017/ Gould A, Masser BM and Thijsen A Getting to know you Life Donor Magazine Winter 2016 3-4

DONOR HEALTH AND WELLBEING Thijsen A First time donation ABC Health report http://www.abc.net.au/radionational/programs/healthreport/first-time-donation/8156566

Flower RL. Post-transfusion complications: Prothrombotic lipid microvesicles in packed red blood cells? Perioperative Patient Blood Management Symposium: The journey of a trauma patient. Brisbane, Australia. 18 Feb 2017

PRODUCT DEVELOPMENT AND STORAGE

Hyland CA, Schoeman EM, Powley T, Liew Y-W, Flower, RL. Red Cell Genotyping The Australian Experience 6th Annual Symposium for “Red Cell Genotyping 2016: Clinical Steps” National Institute of Health (NIH), Bethesda, USA September 21, 2016

Marks DC, Johnson L Frozen forces ABC Health report January 9 2017 http://www.abc.net.au/radionational/programs/healthreport/frozenforces/8156570

McGowan EC, Hyland CA, Bui, X, Jones ML and Flower RL, A gift that keeps on giving? Student Retreat for the UQ Global Change Scholars Program. University of Queensland, June 8, 2017

PRODUCT SAFETY

O’Brien H, Schoeman EM, Millard GM, Flower RL, Hyland CA. Non-invasive Prenatal Testing for Fetal Blood Groups using Droplet Digital PCR. Bio-Rad Advances in Digital PCR Applications and Networking Forum AIBN, University of Queensland, June 1, 2017. O’Brien H, Millard GM, Hyland CA, Schoeman EM, Flower RL, Hyett JA, Gardener GJ. Detection of fetal blood groups in maternal plasma at the Blood Service: observing the impacts of preanalytic variables. Combined AIMs and PaLs State Scientific Meeting Griffith University, Gold Coast June 24-25, 2017. Tung JP. The role of transfusion in exacerbating underlying patient morbidity: What can we learn from models of transfusion and TRALI? Perioperative Patient Blood Management Symposium: The journey of a trauma patient. Brisbane, Australia. 18 Feb 2017

PRODUCT USAGE Hirani R, Analysing molecular changes following blood transfusion Study launch for Lady Cilento Children’s Hospital and John Hunter Children’s Hospital June and November 2016 Knight E, Introduction to Clinical Trials Wollongong University Research Methodology Series October 2016

Masser BM. 612 ABC Evening Radio (Brisbane) on 14/6/16 -http://blogs.abc.net.au/queensland/2016/06/celebrating-blood-and-blooddonors-with-professor-barbara-masser.html?site=brisbane&program=612_evenings.

Marks DC Frozen blood for the military ABC Radio National, PM, 1 June 2017, http://www.abc.net.au/pm/content/2016/s4671405.htm

Balanant M, Barns A Keeping in shape: what happens to red blood cells in storage? Stories of Australian Science http://stories. scienceinpublic.com.au/organisation/australian-red-cross-blood-service/ Gould A, Flower R The blood type you didn’t know you had Life Donor Magazine Spring 2016 11-12 Hyland CA: What are blood groups and why do they matter ABC Local 09/03 10.10am, March 2017 Hyland CA and Flower RL Blood types: the not so bleeding obvious Article for NOVA: Science for curious minds http://www.nova.org.au/ people-medicine/blood-types Hyland C A scarce Sarah: new blood group making transfusions safer Stories of Australian Science http://stories.scienceinpublic.com. au/2017/new-blood-group/ McBean R, Hyland CA The rare Sarah ABC Health report http://www.abc.net.au/radionational/programs/healthreport/the-raresarah/8156568 Viennet, E Measuring the risk of an Australian Zika outbreak Stories of Australian Science http://stories.scienceinpublic.com.au/2017/ zika-risk/

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017

APPENDIX 1 PRODUCT USAGE Hirani R Survey results: O negative red cell use Blood Service in Brief Ed 19 April 2017 Wong J and Dennington P Plasma: the liquid gold running through our veins Article for NOVA: Science for curious minds http://www. nova.org.au/people-medicine/plasma

GENERAL

Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDICES

Gould A, Marks DC, Loh YS and Thijsen A What makes a scientist? Life Donor Magazine Autumn 2017 p1 Gould A It takes all sorts Life Donor Magazine Winter 2017 3-4

BOOKS AND OTHER MATERIALS (INCLUDING THESES) DONOR BEHAVIOUR

INTERNATIONAL DATABASE LISTINGS

Ferguson E, Masser B. Emotions and pro-sociality: Lessons for Blood Donation. In Williams DM, Rhodes RE, Conner MT (Eds). Affective Determinants of Health-Related Behavior. Oxford University Press.

PRODUCT DEVELOPMENT AND STORAGE Waters L, Bachelor of Medical Science Honours (first class) 2016 Characterisation of the ability of platelets to respond to activation signals following cryopreservation. The University of Technology, Sydney.

PRODUCT SAFETY Gorman E Bachelor of Medical Science Honours (first class) 2016. Is parvovirus B19 a concern for blood safety in Australia? Queensland University of Technology Shrestha A Doctor of Philosophy, 2016. Evaluating the Risks Posed by Hepatitis E Virus to Blood Supply Safety, The University of Queensland.

DONOR HEALTH AND WELLBEING Australian New Zealand Clinical Trials Registry [Internet]: Sydney (NSW): NHMRC Clinical Trials Centre, University of Sydney (Australia); 2005 - Identifier ACTRN12617000486325. A three-arm randomised controlled trial comparing the effect of applied muscle tension at different time points to a control condition on reducing self-reported vasovagal symptoms among whole blood donors; 2017 Apr 4. Available from www.anzctr.org.au/ACTRN12617000486325.aspx Australian New Zealand Clinical Trials Registry [Internet]: Sydney (NSW): NHMRC Clinical Trials Centre, University of Sydney (Australia); 2005 - Identifier ACTRN12617000194369. A prospective study to Assess Bacterial load after a non-invasive pain numbing device is placed on a blood donor’s arm after routine disinfection; 2017 February 6. Available from https://www.anzctr.org.au/Trial/ Registration/TrialReview.aspx?id=372220&isReview=true

PRODUCT SAFETY GenBank Accession Number KY302801. Faddy HM, Tran TT, Hoad VC, Seed CR, Viennet E, Chan HT, Harley R, Keller AJ, Hewlett E, Hall RA, Prow NA, Bielefeldt-Ohmann H, Warrilow D, Allcock RJN, Flower RLP. Ross River virus in ‘at-risk’ Australian blood donors: possible implications for blood transfusion safety. GenBank Accession Number KY038382. Millard GM, Hyland CA, O’Brien H, Lopez GH, Schoeman, EM, Flower RL, Hyett, JA and Puddephatt R. Homo sapiens truncated RhD (RHD) gene, RHD*(delEx3) allele, complete cds. Submitted 26 October 2016 GenBank Accession Number KX793704. Lopez GH, Millard GM, Schoeman EM, O’Brien H, McGowan EC, Roulis E, Turner RM, Liew YW, Flower RL and Hyland CA. Homo sapiens RhD blood group antigen (RHD) gene, RHD*del1013bp allele, complete CDS. Submitted: 30 August 2016. GenBank Accession Number KY614793. Lopez,GH, McGowan EC, Schoeman EM, O’Brien H, Millard GM, Roulis EV, Liew YW, Condon JA, Flower RL and Hyland CA. Homo sapiens Rhesus blood group D antigen (RHD) gene, RHD*492G allele, exon 4 and partial cds. Submitted: 12 March 2017.

Ki K Doctor of Philosophy, 2017. Characterisation of dendritic cell immune profile in models of transfusion. The University of Queensland.

Genbank Accession Number MF034879. Schoeman EM, Millard GM, Hyland CA, Flower RL, Liew, YW, Wilson B and Roxby D. Solute carrier family 29 member 1 (SLC29A1, Augustine blood group system) gene, SLC29A1 1159C allele, complete cds. Submitted: 2 May 2017

Colbran R MBBS Honours (first class), 2016 Is the current blood donor questionnaire effective in screening for donor HIV seroconversion? The University of Queensland.

ClinVar Submission ID: SUB2464416. RHD c.1063G>A. Lopez GH, Hyland CA, Liew YW, Flower RL. Anti-D in a mother, hemizygous for the variant RHD*DNB gene, associated with hemolytic disease of the fetus and newborn. Submitted: 07 March 2017.

Assia Moussa Bachelor of Medical Science Honours (first class) 2016 The significance of “Inhibitor of Lutheran” / Krüppel Like Factor 1 mutations in transfusion Queensland University of Technology

ClinVar Submission ID: SUB2812158. Schoeman EM. SLC29A1:c.1159A>C. Augustine blood group, low frequency antigen causing Hemolytic disease of the newborn. Submitted: 26 June 2017 ClinVar Accession Number: SCV000298179.1. Schoeman EM. Blood group--Lutheran inhibitor. KLF1:c.954G>C. Submitted: 29 August 2016 [dbSNP Accession Number: rs769526751] ClinVar Accession Number: SCV000297766.1. Schoeman EM RHD:c.452G>A. Blood group antigen abnormality. Submitted: 10 August 2016 [dbSNP Accession Number: rs879255550]

ClinVar Accession Number: SCV000297765.1. Schoeman EM ABCB6:c.1656-1G>A. Langereis blood group, protein loss of function. Submitted: 10 August 2016 [dbSNP Accession Number: rs879255549]

ClinVar Accession Number: SCV000297764.1. Schoeman EM ABCB6:c.1118_1124delCGGATCG. Langereis blood group, protein loss of function..Submitted: 9 August 2016 [dbSNP Accession Number: rs76592

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017

APPENDIX 2 GRANTS ACTIVE 2016-2017

NEW GRANT APPLICATIONS: SUCCESSFUL

PRODUCT SAFETY

PRODUCT DEVELOPMENT AND STORAGE

$350 000

Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

A new biomechanical model for understanding aging of stored Red Blood Cells (2015-2018) ARC linkage grant Investigators: Flower RF, Faddy H, Gu

$ 4 340 802

Biologics Australia (IC160100027). ARC Industrial Transformation. Training Centre Director: Mahler SM; Chief Investigators: Alexandrov K, Barnard RT, Francois MF, Gray PP, Hodson MP, Hou JJC, Howard CB, Jones ML, Lua LHL, Osborne GW, Schulz BL, Young PR; Partner Investigators: Andrews AE, Bingham JN, Crowley D, Dean MM, Flower RL, Glover DJ, Irving DO, Lee YY, Nisbet IT, Nielsen LK, Oâ&#x20AC;&#x2122;Meara TJ, $599 995

S, Anstey C, Timms D, Brodie D, Moore J, Fanning J, Spooner A, Simmonds M, Molenaar P, Robins E. 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. $4 996 416

Marks DC.

PRODUCT SAFETY $522 580

New vectors, new diseases: Understanding the risk of chikungunya transmission in Australia, NHMRC. Chief Investigators: Frentiu FD, Hu W, Devine GJ, Yakob L, McGraw EA. Associate Investigators: Suhrbier A, Pyke A, Faddy H, Jansen C. (2017-2020)

$9 980

Personalizing Blood Donations: Identification of genetic variations associated with donation-induced iron loss, QUT 2017 Faculty of Health/School of Biomedical Sciences Industry Collaboration Preparedness Pilot Research Support Scheme. Subramaniam N, Haupt L, Rishi G, Flower R, Faddy H.

$10 000

Characterisation of anti-HLA class I mediated transfusion-related acute lung injury (TRALI) using an in vitro microvasculature model. TPCH Foundation New Investigator Grant. New Investigator: Sultana AJ. Mentor Investigator: Tung JP.

$9 995

Nitric oxide scavenging in extracorporeal membrane oxygenation (ECMO): How ECMO induced haemolysis can result in vasoconstriction. New Investigator: Fraser B. Mentor Investigator: Tung JP

$30 000

Intraoperative cell salvage a safer and cost effective alternative to allogeneic blood transfusion.

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

PRODUCT USAGE $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. NHMRC Chief investigators: Ford J (University of Sydney), Irving DO, Nicholl M.(NSW

Appendix 4 - Student projects 66

Kids and Families) $2 761 870

Appendix 5 - Collaborations 70

Advanced Cardio-respiratory Therapies Improving OrgaN Support (ACTIONS). TPCH Foundation Program Grant; Chief Investigators: Fraser JF, Gregory S, Shekar K, Olive C, Tansley G, Platts D, Tung JP, McGiffin D, Thomson B, Bull T; Associate Investigators; Barnett A, Bannon P, Marasco

$949 279

The role of neuraminidases in platelet function in general and during storage. ANZSBT Research Fund. Chief Investigators: van der Wal DE and

Australian Research Council (ARC) Training Centre for Biopharmaceutical Innovation: UQ, CSL, Australian Red Cross Blood Service, Patheon

Owczarek CM, Panousis C, Sandford VM, Shave E, Tung JP, Wilson MJ.

APPENDICES

$16 660

YT, Sauret E, Saha S, Xiao Y

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)

$190 274

FEISTY: Fibrinogen Early In Severe Trauma study. Fibrinogen Concentrate vs Cryoprecipitate in Traumatic Haemorrhage: A Pilot Randomised Controlled Study. National Blood Authority R&D Pilot; Chief Investigators: Winearls J, Wullschleger M, Campbell D, Fraser J, Dyer W; Associate Investigators; Tallot M, Bodnar D, Cohen J, Trout M, Presneill J, Keijzers G, Paxton J, Walsham J, Walters K, Wake E, Shuttleworth M, Czuchwicki S, Mondy P, Ryan G, Englebrecht S, Hurn C, Furyk J.

$292 397

Fibrinogen Concentrate vs. Cryoprecipitate in Traumatic Haemorrhage: A Pilot RCT. QLG Emergency Medical Research Foundation; Chief Investigators: Campbell D, Hurn C, Winearls J, Wullschleger M; Associate Investigators; Furyk J, Ryan G, Presneill J, Fraser J, Keijzers G, Dyer

W, Shuttleworth M.

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDICES

APPENDIX 3 ABSTRACTS ACCEPTED FOR ORAL OR POSTER PRESENTATIONS DONOR BEHAVIOUR

in young whole blood donors. 34th International Congress of the ISBT, 3-8 September 2016. Dubai, United Arab Emirates. (Poster)

Carver A, Chell K, Davison TE, Masser BM. Understanding motivators for blood donation among men: A review of the evidence. The 34th International Congress of the International Society of Blood Transfusion. September 2016. Dubai, UAE. (Poster)

Wright ST, Carver A, Davison TE, Gemelli CN, Thijsen A, Irving DO. Extended Donor Vigilance: a data linkage study to evaluate health outcomes in older blood donors. 45 and Up Study Collaborators Day, 6 September 2016. Sydney, Australia (Oral)

Carver A, Chell K, Davison TE, Masser BM. What motivates men to donate blood? 2nd European Conference on Donor Health and Management. July 13-15 2016, Cambridge, UK. (Poster)

Thijsen A, O’Donovan J, Bell B, Fisher J, Jensen K, Davison TE, Gemelli CN, Carver A, Masser B. The crucial role of blood collection staff in preventing and managing vasovagal reactions. 27th Regional Congress of the ISBT, 17-21 June 2017. Copenhagen, Denmark. (Poster)

Chell K The varied impact of online donor acknowledgement and recognition as donor relationship enhancing strategies. International Social Marketing Conference. 25-27 September 2016. Wollongong, Australia (Oral)

Wright ST, Gemelli CN, Thijsen A, Van Dongen A. So just how healthy are older Australian Blood Donors? Examining the healthy donor effect. 27th Regional Congress of the ISBT, 17-21 June 2017. Copenhagen, Denmark. (Oral)

Chell K, Edwards C, Neill J. Matching message with motivation: A functional approach to encouraging blood donation. Australian and New Zealand Marketing Academy Conference. 5-7 December 2016. Christchurch, New Zealand. (Oral)

Chell K, Russell-Bennett R, Mortimer G. Donate, smile and share? Exploring motivations to share online donor recognition on Facebook. Australian and New Zealand Marketing Academy Conference. 5-7 December 2016. Christchurch, New Zealand. (Oral)

Gemelli CN, Thijsen A, Wright ST, Davison TE. The impact of temporary deferrals on return behaviour of plasmapheresis donors. The 2nd European Congress of Donor Health & Management. July 2016. Cambridge, UK. (Poster)

Hyland R, Wood B, L Johnson L, Marks D. Maximising platelet usage by delaying refrigerated storage. 27th Regional Congress of the ISBT, June 17–21, 2017, Copenhagen, Denmark (Poster).

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59

Masser BM, Williams LA, Sun J. If you want to motivate them to donate, should you stick a face on it? 2nd European Conference on Donor Health and Management. July 13-15 2016, Cambridge, UK. (Poster)

Johnson L, Choi C, Marks DC. Coagulation factor binding to platelets and microparticles: potential mediators of the procoagulant activity of cryopreserved platelets. The Annual Meeting of the AABB, 22-25 October 2016, Florida USA (Poster)

Thijsen A, van Dongen A, Davison T, Masser B, Williams L. Emotions and blood donation: which and when matter for donor return. Society of Australasian Social Psychologists Annual Meeting. 20-22 April 2017. Melbourne, Australia. (Oral)

Johnson L, Tan S, Hyland RA, Noorman F, JBadloe JF, Dumont LJ, Marks DC. An interlaboratory comparison of cryopreserved platelet quality. The Annual Meeting of the AABB, 22-25 October 2016, Florida USA (Poster)

Van Dongen A, Williams L, Masser B. The emotional psychology of blood donors: understanding and using the affective key to donor return. The 37th Regional Congress of the International Society of Blood Transfusion. 17-21 June 2017. Copenhagen, Denmark. (Oral)

Johnson L, Jenkins E, Wood BW, Marks DC. Lectin mapping reveals differences in glycosylation patterns on platelet proteins following cryopreservation and cold storage. The Annual Meeting of the AABB, 22-25 October 2016, Florida USA (Poster)

DONOR HEALTH AND WELLBEING

Loh Y, Su Y, Costa M, Marks D. Production and quality of allogeneic platelet gel produced by precipitation of expired apheresis platelet concentrates. 27th Regional Congress of the ISBT, June 17–21, 2017, Copenhagen, Denmark (Poster).

Appendix 3 - Abstracts accepted for oral or poster presentations 60 Appendix 4 - Student projects 66 Appendix 5 - Collaborations 70

Gemelli CN, Thijsen A, Wright ST, Davison TE. Examining trends in first-time plasmapheresis donors’ return behaviour: Why do some donors only donate once? The 34th International Congress of the International Society of Blood Transfusion. September 2016. Dubai, UAE. (Oral)

Wright ST, Ryan LM, Pham T. A Novel Case-Control Subsampling Approach for Rapid Model Exploration of Large Clustered Binary Data. International Biometrics Conference, 12th July 2016. Victoria, Canada (Oral) Thijsen A, Waller D, Gemelli CN, Davison TE. Improving our understanding and prediction of vasovagal reactions in blood donation. 2nd European Conference on Donor Health and Wellbeing. July 13-15 2016, Cambridge, UK. (Oral). Masser BM, Jensen K. Can persuasive communication after an adverse physical experience change the way people interpret the event? 2nd European Conference on Donor Health and Wellbeing. July 13-15 2016, Cambridge, UK. (Poster)

Thijsen A, Davison TE, Bell B, Fisher J, O’Donovan J, Bramble C, Del Aguila C, Masser B. A randomised trial to facilitate donor compliance with strategies to prevent vasovagal reactions: comparison of web-based and in-centre approaches. 34th International Congress of the ISBT, 3-8 September 2016. Dubai, United Arab Emirates. (Oral)

Davis AM, Johnson L, Veale MF, Raynel S, Hyland RA, Marks DC. The role of microparticles in mediating adhesion of cryopreserved platelets to collagen. HAA2016, November 13-16 2016, Melbourne, Australia (Poster) Hyland RA, Cha Y, Marks DC. Adapting Lean Methodology to Improve Workflow in a Research and Development Laboratory The Annual Meeting of the AABB, 22-25 October 2016, Florida USA (Oral).

Loh Y, Costa M, Lu Z, Marks DC. Characterization of platelet lysate produced from expired platelet components: suitability for expansion of mesenchymal stromal cells. The Annual Meeting of the AABB, 22-25 October 2016, Florida USA (Oral) Marks DC, van der Meer PF, Best Collaborative. Serum eye drops: a survey of international production methods. The Annual Meeting of the AABB, 22-25 October 2016, Florida USA (Poster) Tan JC, Webb RG, Marks DC. Serum growth factor and fibronectin concentrations in dry eye patients and healthy blood donors. The Annual Meeting of the AABB, 22-25 October 2016, Florida USA (Poster) Tohidi-Esfahani I, Tan S, Johnson L, Chen V, Marks DC. Identification of procoagulant platelet subsets in cold-stored and cryopreserved platelets using a novel cell death marker. 27th Regional Congress of the ISBT, June 17–21, 2017, Copenhagen, Denmark (Oral).

Mondy P, Brama T, Thijsen A, Waller D, Irving DO, Fisher J, Shuttleworth G, Bell B. Vein suitability scoring to predict phlebotomy outcomes 60

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDIX 3 ABSTRACTS ACCEPTED FOR ORAL OR POSTER PRESENTATIONS Waters L, Padula M, Marks D, Johnson L. Cryopreserved platelets demonstrate a reduced response to collagen stimulation. 27th Regional Congress of the ISBT, June 17–21, 2017, Copenhagen, Denmark (Poster).

Ross River virus in ‘at-risk’ Australian blood donors: implications for blood supply safety. 34th International Congress of the ISBT, 3-8 September 2016, Dubai UAE (Oral presentation)

Webb RG, Winter KM, Johnson L, Marks DC. Comparison of additive solutions for the storage of thawed deglycerolised red cells. HAA2016, November 13-16 2016, Melbourne, Australia (Poster)

Faddy HM, Tran T, Seed C, Chesneau S, Ismay S, Hogan C, Flower R. Cytomegalovirus-seronegative component supply and demand: are we able to meet our future needs? 34th International Congress of the ISBT, 3-8 September 2016, Dubai UAE (Oral presentation)

Webb RG, Winter KM, Hyland RA, Tan S, Davis AM, Dennington PM, Marks DC. Extending the post-thaw shelf-life of cryoprecipitate. HAA2016, November 13-16 2016, Melbourne, Australia (Oral)

Faddy H. Chagas disease and blood transfusion safety: An Australian perspective. International Congress for Tropical Medicine and Malaria, 18-22 September 2016, Brisbane, Australia. (Invited Presentation)

Winter KM, Webb RG, Johnson L, Marks DC. A comparison of additive solutions (SAG-M, AS-3 & ESOL-5) for storage of thawed deglycerolised red cells. 34th International Congress of the ISBT, September 3-8, 2016, Dubai, United Arab Emirates. (Oral)

Faddy H. Dengue fever in Australia: Clinical features, outbreaks & prevention. AACB AIMS 2016 Combined Scientific Meeting, Brisbane, 15 September 2016, Brisbane, Australia. (Invited Presentation)

Winter KM, Hyland RA, Tan S, Webb RG, Davis A, Dennington PM, Marks DC. Extending the post-thaw shelf-life of cryoprecipitate. 34th International Congress of the ISBT, September 3-8, 2016, Dubai, United Arab Emirates. (Poster)

Faddy HM, Shrestha AC, McGrath O, Nimmo G, Gibb R, Flower RLP. Hepatitis E virus infection in a cohort of patients with acute hepatitis. Communicable Diseases Control Conference 26-28 June 2017. Melbourne, Australia. (Poster).

Wood BW, Padula M, Marks DC, Johnson L. Characterization and comparison of the surface phenotype of refrigerated and cryopreserved platelets. The Annual Meeting of the AABB, 22-25 October 2016, Florida USA (Oral)

Faddy HM, Gorman E, Hoad V, Frentiu F, Tozer S, Bialasiewicz S, Flower RLP. Seroprevalence of antibodies to primate erythroparvovirus 1 in Australia. Communicable Diseases Control Conference 26-28 June 2017. Melbourne, Australia. (Poster).

PRODUCT SAFETY

Flower RL, Pi-Hsiang L, Hyland CA, Lopez GH. Frequency of GP.Hut in association with ‘Mi(a)-positive’ serology in Asian populations. Pathology Update, Sydney, Australia 24-26 February 2017. (Poster)

Balanant MA, Dean MM, Flower RL, Sauret E, SC Saha, YT Gu. Storage-Related Morphological Changes in Red Blood Cells: Telling the Whole Story. HAA Joint Scientific Meeting, 13 – 16 November, 2016. Melbourne, Australia. (Poster presentation) Colbran R, Dean MM, Harley R, Flower R, Styles C, Shuttleworth G, Faddy H. Does questioning donors about acute retroviral syndrome assist in maintaining HIV transfusion safety? HAA Joint Scientific Meeting, 13 – 16 November, 2016. Melbourne, Australia. (Poster presentation)

Flower R, Balanant MA, Dean M, Sauret E, Saha S, Gu YT. Reversal of storage-related morphological changes in red blood cells: what is the impact in microcirculation? 16 th International Conference on Biomedical Engineering, Singapore 7-10 December 2016 (oral) Fryk JJ, Hoad VC, Flower RLP, Seed CR, Perkowska Z, Hogema B, Tran TV, Hewlett E, Faddy HM. Prevalence of hepatitis E virus in Australian whole-blood donors during 2016. Pathology Update 24-26 February 2017. Sydney, Australia. (Poster).

Dean MM, Perros AJ, Ki KK, Samson LD, Rooks K, Chong F, Luimstra J, Flower RL. Development of laboratory assays for multiple parallel assessments of recipient immune responses for use in clinical studies of transfusion outcomes. HAA Joint Scientific Meeting, 13 – 16 November, 2016. Melbourne, Australia. (Oral presentation)

Dean MM, Rooks KM, Chong FN, Faddy HM, Tung JP, Flower RL. Do donor and/or processing-related differences impact on blood product quality? 34th International Congress of the ISBT, 3-8 September 2016, Dubai UAE (Oral presentation)

Gorman EC, Flower RLP, Hoad VC, Frentiu FD, Faddy HM. Seroprevalence of antibodies to primate erythroparvovirus 1 among Australian blood donors. Pathology Update 24-26 February 2017. Sydney, Australia. (Poster).

Dean MM, Rooks KM, Chong FN, Faddy HM, Tung JP, Flower RL. Do donor and/or processing-related differences impact on blood product quality? HAA Joint Scientific Meeting 13-16 November 2016. Melbourne Australia (Poster)

Gordon LG, Hyland CA, Hyett JA, O’Brien H, Millard GM, Flower RL, Gardener GJ. Cost-effectiveness analysis of fetal RHD genotyping of RhD negative pregnant women for targeted versus universal anti-D therapy in Australia. 3rd International Meeting on Cell-free DNA, Copenhagen, Denmark; 6-7 April 2017 (Poster)

Dean MM, Ki K, Henry S, Faddy HM, Flower RL. Mechanisms underpinning transfusion related immune modulation: erythrophagocytosis and immune modulation in different myeloid cell subsets. 34th International Congress of the ISBT, 3-8 September 2016, Dubai UAE (Poster presentation) Dean MM, Perros AJ, Esguerra-Lallen A, Rooks K, Chong FN, Engkilde Pedersen S, Naidoo R, Tung JP, Fraser J, Tesar P, Ziegenfuss M, Smith S, O’Brien D, Flower RL. Patient monocyte responses modulated following cardiac surgery. 14th International Conference on Innate Immunity, June 19-24 2017, Crete Greece. (Poster presentation)

Harley D, Viennet E, Faddy H, Dteinmuller S, Ritchie S, Williams C. Weather, air travel, and health services: dengue fever in far north Queensland. International Congress for Tropical Medicine and Malaria, 18-22 September 2016 Brisbane, Australia. Hoad VC, Seed CR, Fryk J, Harley R, Flower RLP, Hogema B, Faddy HM. Prevalence of hepatitis E virus in whole blood donors; Australia is different! Communicable Diseases Control Conference 26-28 June 2017. Melbourne, Australia. (Oral)

Dean MM, Ki KK, Faddy HM, Johnson L, Marks D, Flower RL. Characterisation of DC immune profile in transfusion models. 14th International Conference on Innate Immunity, June 19-24 2017, Crete Greece. (Poster presentation)

Hyland CA, Millard GM, McGowan EC, O’Brien H, Lopez GH, Schoeman EM, Flower RL. African and Asian RHD blood group genotypes as a complication of non-invasive prenatal testing (NIPT). 34th International Congress of the ISBT, Dubai, United Arab Emirates 03-08 September 2016. (Oral)

Faddy HM, Tran T, Hewlett E, Seed CR, Hoad V, Chan HT, Harley R, Keller A, Hall RA, Prow N, Bielefeldt-Ohmann H, Flower RLP.

Hyland CA, Schoeman EM, Powley T, Wilson B, Martin JR, Liew YW, Lopez GH, Millard GM, McGowan EC, O’Brien H, Flower RL. Evaluation

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDIX 3 ABSTRACTS ACCEPTED FOR ORAL OR POSTER PRESENTATIONS of targeted exome sequencing for 28 blood group systems, including homologous gene systems, for comprehensive blood group genotyping. 34th International Congress of the ISBT, Dubai, United Arab Emirates 03-08 September 2016 (Oral)

Damage in a Sheep Model of Transfusion-Related Lung Injury: Role of Red Blood Cell Storage Duration and Heat Treatment. American Society of Clinical Pathology Annual Meeting. 14-16 September 2016, Las Vegas, USA. (Poster)

Hyland CA, Gardener GJ, Baidya S, O’Brien H, Millard GM, McGowan EC, Lopez GH, Schoeman EM, Liew YW, Flower RL. A case of suspected confined placental chimerism following detection of fetal RHD signals in maternal plasma discordant with the newborn serology. 34th International Congress of the ISBT, Dubai, United Arab Emirates 03-08 September 2016. (Poster)

Simonova G, McGowan E, Dean MM, Wattegedera S, Entrican G, Tung JP. Development of cytometric bead array assays to quantify sheep cytokines. International Veterinary Immunology Symposium, 16 – 19 August 2016, Gold Coast, Australia. (Oral)

Hyland CA, Millard GM, O’Brien H, Flower RL, Hyett JA, Gardener GJ. Non-invasive prenatal testing (NIPT) for Fetal RHD in twin pregnancies. HAA Annual Scientific Meeting. Melbourne, Victoria, Australia 13-16 November 2016 (Oral – Presidential Symposium)

Sultana A, Meka D, Dean MM, Simonova G, Christensen AM, Flower RL, Tung JP. The potential of inflammatory responses to contribute to the development of transfusion-related acute lung injury (TRALI). International Congress of immunology, 21 -26 Aug 2016, Melbourne Australia. (Oral).

Hyland CA, O’Brien H, Schoeman EM, Millard GM, Hogan C, Liew YW, Morrison J, McGrath KA, Flower RL, Hyett JA, Gardener GJ. Application of a Droplet Digital PCR (ddPCR) Assay for Non-Invasive Detection of Fetal KEL*01.01 in Isoimmunised Pregnancies. HAA Annual Scientific Meeting. Melbourne, Victoria, Australia 13-16 November 2016 (Poster)

Sultana AJ, Meka D, Dean MM, Simonova G, Christensen AM, Flower RL, Tung JP. The potential of inflammatory responses to contribute to the development of transfusion-related acute lung injury (TRALI). International Congress of Immunology. 21- 26 August 2016. Melbourne. Australia. (Oral)

Hyland CA, Schoeman EM, Powley T, Wilson B, Martin J, Liew YW, Lopez GH, Millard GM, McGowan EC, O’Brien H, Flower RL. ‘Can extended genotyping, using comprehensive and targeted blood group sequencing, assist in resolving complex serology problems in chronic transfused patients? HAA Annual Scientific Meeting. Melbourne, Victoria, Australia 13-16 November 2016 (Oral)

Tung JP, Simonova G, Diab S, Dunster K, Passmore M, Roche E, Bierman W, Meka D, Dean MM, Fraser J. A Preliminary Analysis of the Incidence of Transfusion-Related Acute Lung Injury (TRALI) in a Sheep Model Following Transfusion with the Supernatant from Leukodepleted Red Cell Units. American Society of Haematology Annual Meeting, 3-6 December 2016, San Diego, USA. (Poster)

Knauth C, Hyland CA, Flower RL. Routine prophylactic use of RhD immunoglobulin in Australia: comparison with international practice. HAA Annual Scientific Meeting. Melbourne, Victoria, Australia 13-16 November 2016 (Poster)

Tung JP, Simonova G, Engkilde-Pedersen S, Esguerra-Lallen A, Sultana AJ, Hewlett E, Obonyo N, Millar J, Flower RL, Fraser JF. Pointof-care testing in an ovine model of transfusion-related acute lung injury (TRALI). Pathology Update. 24-26 February 2017. Sydney, Australia. (Poster)

Ki KK, Johnson L, Faddy HM, Flower RL, Marks DC, Dean MM. Exposure to cryopreserved platelets mediates suppression of myeloid dendritic cell subset immune responses. Pathology Update 24-26 February 2017. Sydney, Australia. (Poster). Lopez GH, Turner RM, McGowan EC, Schoeman EM, Liew YW, Flower RL, Hyland CA. A novel molecular mechanism in RHD caused the deletion of Exon 9 resulting in a partial DEL phenotype. HAA Annual Scientific Meeting. Melbourne, Victoria, Australia 13-16 November 2016 (Oral) Marks DC, Fryk JJ, Hobson-Peters J, Watterson D, Hall RA, Young PR, Reichenberg S, Tolksdorf F, Sumian C, Gravemann U, Seltsam A, Faddy HM. Zika virus infectivity is reduced following treatment with the THERAFLEX UVC-Platelet and THERAFLEX MB-Plasma systems. 27th Regional Congress of the ISBT 17-21 June 2017. Copenhagen, Denmark. (Poster).

Viennet E, Mincham G, Frentiu F, Jansen C, Montgomery B, Harley D, Flower R, Williams C, Faddy H. Epidemic potential for local transmission of Zika virus in 2015-2016, in Queensland, Australia. 12th Mosquito Control Association of Australia and 9th Arbovirus Research in Australia Symposium, 7 September 2016, Surfers Paradise. (Oral) Powley T,Thyer J, Gould A, Hyland C, Wong J, 50 Years of RhD immunoglobulin (anti-D) therapy in Australia. 27th Regional Congress of the ISBT 17-21 June 2017. Copenhagen, Denmark. (Poster)

Moussa A, Knauth C, Walsh T, Dean MM, Hyland C, Liew YW, Schoeman EM, Wilson B, Turner R, Flower RL. In(Lu) / KLF1 in Australian blood donors. HAA Joint Scientific Meeting, 13 – 16 November, 2016. Melbourne, Australia. (Poster presentation)

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. Poster Presentation HAA Meeting 2016 Melbourne, Australia.

Passmore M, Fung YL, Foley S, Simonova G, Dunster K, Diab S, Tung JP, Minchinton R, McDonald C, Anstey C, Shekar K, Fraser JF. Inflammation and Lung Remodelling in an Ovine Model of Extracorporeal Membrane Oxygenation Support. International Veterinary Immunology Symposium. 16-19 August 2016. Gold Coast, Australia. (Poster)

PRODUCT USAGE

Perros AJ ,Esguerra-Lallen A, Rooks K, Chong FN, Flower RL, Engkilde-Pedersen S, Naidoo R, Tung JP, Fraser J, Tesar P, Ziegenfuss M, Smith S, O’Brien D, Dean MM. Modulation of immune responses in patients following cardiac surgery. Pathology Update 24-26 February 2017. Sydney, Australia. (Poster).

Tung JP, Wattegedera S, Entrican G, Simonova G. Evaluation of the ability of commercial assays to quantify sheep cytokines. International Veterinary Immunology Symposium. 16-19 August 2016. Gold Coast, Australia. (Poster)

Perros, AJ, Flower RL, Christensen AM, Dean MM. Transfusion-related immunomodulation: Importance of cell-to-cell interactions in studying underlying mechanisms. International Congress of immunology, 21 -26 Aug 2016, Melbourne Australia. (Poster). Roche E, Passmore MR, Simonova G, Diab SD, Dunster KR, Bierman K, Fraser JF, Tung JP. A Histologic Approach to Qualify Lung Tissue

Hirani R, Wong J, Diaz P, Pink, J, Hogan C, Mondy P, Dennington PM, Irving DO Group O D negative red blood cell usage in Australia. HAA conference Melbourne 13-16th November 2016 (Poster) Hirani R, Tohidi--Esfahani I, Diaz P, Langshaw M, Mondy P, Irving DO The fate of blood products derived from cytomegalovirusseronegative donors at three tertiary referral hospitals: a pilot study Royal College of Pathology Update Sydney 24-26 February 2017 (Oral) Mondy P, Hirani R, Perberdy J, Hughes C, Botterill C. Can “historical donor platelet counts” be used for programming platelet donation?. ISBT conference Copenhagen 17-21 June 2017 (Poster)

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

APPENDICES

APPENDIX 4 STUDENT PROJECTS R&D team members collaborate with universities, research institutes and hospitals to support students who undertake 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. Students who hold scholarships are indicated by an asterisk.

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

Queensland University of

(completed)

Dr Francesca Frentiu

Technology

Hon Hwang

Prof Louise M. Ryan (primary),

University of Technology

PhD

Sydney, Australia.

Stephen T. Wright (honorary) Yu Ji*

A/Prof Melinda Dean, Prof Robert

Characterisation of Red Blood Cell Phagocytosis and

Flower

Assessment of Nanoparticles as Novel Treatment-Delivery Technology

STUDENT NAME

SUPERVISORS

Timothy An

Dr Helen Faddy, A/Prof Melinda

Occult Hepatitis C Infection: Is There a Risk to Transfusion The University of

MBBS Research

Esvara Kumar

Dean, Prof Robert Flower

Safety?

Queensland

Scholar

(completed)

Marie Anne Balanant, Dr John-Paul

Red cell storage duration and procoagulant effects: Role

ONIRIS (College of Food

Masters in

Melanie Mach

A/Prof Denese Marks, Dr Dianne

The role of deglycosylation in platelet function and during

and Health Science and

Biotechnology of

(completed)

van der Wal

storage

Technology Engineering),

Health

Geekiyanage

Dr Emilie Sauret, Prof YuanTong

Nadeeshani

Gu, A/Prof Robert Flower, and Dr

Maheshika*

Suvash Saha

Eunike McGowan *

(completed)

Tung , Prof Robert Flower Dr

PROJECT TITLE

of microparticles and smaller particles

Natalie Pecheniuk

INSTITUTION

Degree

France Marie Anne Balanant*

Prof YuanTong Gu, Prof Robert

Experimental study of the aging effects on the Red Blood

Queensland University of

Flower, Dr Emilie Sauret and Dr

Cell membrane during storage

Technology

PhD

Katrina Ki (completed)

Queensland University of

PhD

Sarah Barns*

Prof Yuan Tong Gu, Dr Emilie

Numerical Modelling of Red Blood Cell Morphological and Queensland University of

Sauret, Prof Robert Flower

Deformability Changes during the Cell Aging Process in

A/Prof Frank van Haren, Dr John-

Fluid resuscitation during sepsis: Effects upon the

Australian National

Paul Tung, Prof John Fraser

microcirculation

University

Kathleen Chell

Prof Rebekah Russell-Bennett, Dr

Giving and sharing : The predictors and outcomes of

Queensland University of

(completed)

Gary Mortimer, Dr Geoff Smith

online donor appreciation

Technology

Anne-Marie

Dr Damien Harkin, A/Prof Melinda

Extracellular traps and TRALI: more than just neutrophils

Christensen

Dean, Dr John-Paul Tung, Prof

Queensland University of

Amanda Thijsen & Dr Phillip Mondy Feasibility and development of a vein assessment tool in

Numerical investigation of recoverability of morphological

Queensland University of

PhD

and deformability changes of stored red blood cells.

Technology

A/Prof Catherine Hyland, Dr Elizna

The gift that keeps giving: novel approaches to anti-D

The University of

Schoeman, Prof Stephen Mahler,

therapy

Queensland

Prof Michael Reade, Dr John-Paul

Effects of commonly used and emerging resuscitation

The University of

Tung

fluids on end organ function in severe trauma

Queensland

Assia Moussa

Christine Knauth, Prof Terry

The significance of “Inhibitor of Lutheran” / Krüppel Like

Queensland University of

(completed)

Walsh, Dr Elizna Schoeman, A/

Factor 1 mutations in transfusion

Technology

Prof John Fraser, Dr John-Paul

The double whammy: impact of activated endothelium

The University of

Tung

and stored blood transfusion on microparticle formation

Queensland

blood donation

(completed)

Dean, Prof Robert Flower, Dr Robert screening for donor HIV seroconversion?

Flower PhD

Monica Ng*

Is the current blood donor questionnaire effective in

The University of

MBBS Hons

Alexis Perros*

Queensland

PhD

A/Prof Melinda Dean, Dr Helen

Investigation of transfusion-related modulation of dendritic The University of

Faddy, A/Prof Stuart Kellie, Prof

cell function in cardiac surgery patients

PhD

Queensland

Robert Flower

Harley Isolation of novel typing antibodies that bind hybrid glycophorins on red blood cells

The University of

PhD

Sandra Sowah*

Queensland

Xuan Bui, Dr Martina Jones, Prof Lanny Ramadi

Robert Flower.

Honours

and thrombosis

Dr Helen Faddy, A/Prof Melinda

Nicole Fraser

PhD

Prof Catherine Hyland, Prof Robert

PhD

Robert Flower

A/Prof Catherine Hyland, Dr Eileen

PhD

Dr Xuan Bui, A/Prof Robert Flower

Technology

Rachel Colbran

Serena Ekman*

PhD

Queensland

Summer student

Elissa Milford

PhD

of transfusion

University of Sydney

Storage Liam Byrne

Characterisation of dendritic cell immune profile in models The University of

Faddy, Prof Robert Flower

Summer student

PhD

Technology

A/Prof Melinda Dean, Dr Helen

University of Sydney

Suvash Saha

Roulis, Prof Stephen Mahler, Dr

Coarsening Strategies for Big Data

Prof Matt Wand (secondary), Dr

Honours

Systems

Amelie Babinet

Elise Gorman

Christine Knauth, A/Prof Terry

Gene variations of KLF1 and their Variable Effects on

Queensland University of

Walsh, Dr Elizna Schoeman, A/

Blood Groups and Haemoglobin Types in In(Lu) Blood

Technology

Prof Catherine Hyland, Prof Robert

Donors

Honours

A/Prof Melinda Dean, Prof Stephen Identifying novel red blood cell targets as a basis for

The University of

PhD

Queensland

Mahler, Dr Xuan Bui, Dr Martina

development of biopharmaceuticals for treatment of

Jones, Prof Robert Flower.

infectious diseases

Prof Louise Hafner, Prof Robert

Extended Blood Group Genotyping to solve complex Blood Queensland University of

Flower, A/Prof Catherine Hyland,

Group Serology and to Identify Rare Donors

PhD

Technology

Prof David Irving, Dr Elizna Schoeman

Flower

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

APPENDIX 4 STUDENT PROJECTS Katelyn Richards*

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

Ashish Shrestha Beatrice Sim

PhD

Queensland

Mahler, Dr Xuan Bui, Dr Ben

and their role in red blood cell maturation, lifespan and

Schultz, Prof Robert Flower.

disease resistance.

Prof Robert Flower, Dr Helen Faddy

Evaluating the Risks Posed by Hepatitis E Virus to Blood

The University of

Supply Safety

Queensland

Blood transfusion and risk of sepsis

MPhil

Dr John-Paul Tung, A/Prof Melinda

Developing laboratory models to help translate findings

PhD

Dean, Prof Robert Flower, Prof

from the sheep model to the clinical setting

Dr Celine Loh, A/Prof Denese Marks Development and characterisation of platelet gel

University of Sydney

Summer student

Dr John-Paul Tung, A/Prof Melinda

Investigation of different mechanisms that contribute to

PhD

Dean, Prof Robert Flower, Prof

the development of transfusion-related acute lung injury

Michael Reade

(TRALI)

Prof John Fraser, Prof Adrian

A retrospective analysis of pre-transfusion haemoglobin,

MPhil

Barnett, Dr John-Paul Tung

haematocrit, and patient outcomes in all Queensland

(completed) Prof John Fraser, Dr John-

PhD

Paul Tung Gabriela Simonova*

APPENDICES

Michael Reade

Yufei Su (completed) Annette Sultana*

Matthew Tunbridge

inpatients from 2007 â&#x20AC;&#x201C; 2013 Shaba Vakalia

Dr Rena Hirani, Prof Robert Flower, An evaluation of the benefits of blood group genotyping in QUT

PhD

Prof Louise Hafner, David Irving, A/ chronically transfused recipients Prof Catherine Hyland Lauren Waters

Dr Lacey Johnson

Characterisation of the ability of platelets to respond to

University of Technology

Bachelor of Medical

(completed)

Dr Matthew Padula

activation signals following cryopreservation

Sydney

Science (Honours)

Peter Watson-Brown

Dr Helen Faddy, Dr Elvina Viennet,

Assessing the Risk of Zika Virus Transmission in Australia

The University of

MBBS Hons

Prof Robert Flower Kelly Wray

A/Prof Denese Marks, Dr Kelly

Queensland Lipaemic plasma effect on red cell haemolysis

University of Sydney

The risk of allergic reactions due to transfer of medication

The University of

MBBS Research

Queensland

Scholar

Professor Matt Wand (primary), Dr Revisiting Regression to the Mean

University of Technology

PhD

Stephen T. Wright (secondary)

Sydney, Australia.

Winter Michael Wu

Dr Helen Faddy, A/Prof Melinda

Summer student project

Dean, Prof Robert Flower, Dr Robert in blood products: a pilot study

Appendix 5 - Collaborations 70

Harley James Yu

A/Prof Melinda Dean, Prof Stephen An analysis of systems that modify red blood cell antigens The University of

INTENTIONALLY LEFT BLANK

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

APPENDIX 5 COLLABORATIONS INSTITUTION

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

RESEARCH AREA AND PROJECT

COLLABORATOR(S)

Product safety: Novel red cell targets for biopharmaceuticals

Dr Benjamin Shultz

Product safety: Novel red cell targets for biopharmaceuticals

Prof Simon Foote, Dr Brendan McMorran, Dr

Product usage: Clip Trial - Cryopreserved versus Liquid Stored Platelets for

Prof Michael Reade

Gaétan Burgio

surgical bleeding

Donor behaviour: Hospitals to Hospitality: Understanding the influence of

UNIVERSITIES Australian National University James Cook University

Product safety: Exotic mosquito-borne virus threats to Australia (including WNV,

Prof. John McBride

Dr Josephine Peevite

Interaction with staff and service quality on donor intention to donate

University of South Australia

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

Product safety: Chikungunya and/or Zika virus emergence and establishment in

A/Prof Craig Williams, Gina Mincham

Australia University of Sydney

Donor Behaviour: Behavioural economics to understand blood donations

Evarn Ooi co-appointment with Prof Robert

APPENDICES

Monash University

Product usage: Transfusion Outcomes Research Collabrative (TORC)

Prof J Mc Neill and members of the TORC Steering committee

Centre for Values, Ethics and the Law in Medicine: APPRISE partner

Prof Angus Dawson

Murdoch University

Product safety: Red cell storage duration and procoagulant effects: Role of

Ross Baker and Quentin Hughes

Product development and storage: Development and characterisation of platelet

Dr Zufu Lu

microparticles and smaller particles Queensland University of Technology Product safety: Red cell alloimmunisation: How can extended genotyping support

lysate Prof Louise Hafner University of Technology Sydney

the ongoing transfusion needs of haemoglobinopathy patients?

Louise Ryan Dr Stephen Wright (co-appointment)

Product safety: reducing the risk of TRALI and related projects

Prof Adrian Barnett, Anne-Marie Christensen

Donor behaviour: Hospitals to Hospitality: Understanding the influence of

Prof Rebekah Russell-Bennett

Product development and storage: Characterisation of cryopreserved platelets

Product safety: Points of structural failure that may lead to storage-related

Prof YT Gu, Dr E Sauret, Dr S Saha and Prof Y

Product development and storage: Cold storage of platelets

changes of red cells

Xiao, Sarah Barns, Dr Alex Stilgoe

HOSPITALS

Product safety: What is the risk of alloimmunisation by transfusion of variant RhD

Christine Knauth

Canberra Hospital

red blood cells that serotype as RhD Negative?

Appendix 3 - Abstracts accepted for oral or poster presentations 60 University of Newcastle

Dr Matthew Padula

Appendix 5 - Collaborations 70 University of Queensland

Prof Matthew Cook, Dr Zuopeng Wu

Product safety: Is parvovirus B19 a concern for the blood safety in Australia?

Dr Francesca Frentiu

Concord Repatriation and General

Product usage: Blood product safety in massive transfusion recipients - Does

Product safety: Red cell storage duration and procoagulant effects: Role of

Dr Natalie Pecheniuk

Hospital

white cell filtration really remove transfusion risk?

microparticles and smaller particles

Flinders Medical Centre

The incidence of microchimerism in chronically transfused patients

A/Prof. David Roxby

Product safety: Q Fever: how common is it, who is at risk and what does this mean Prof Stephen Graves

Gosford Hospital

Product usage: Blood product safety in massive transfusion recipients - Does

Dr Duncan Reed

for blood safety? University of NSW

Product safety: Investigating levels of BRMs in donors implicated in clinical cases of TRALI

Prof Peter Maitz , Dr Rosalba Cross

white cell filtration really remove transfusion risk?

Product safety: Q Fever: how common is it, who is at risk and what does this mean Dr Heather Gidding

John Hunter Hospital

for blood safety?

Donor health and wellbeing: biostatistics, several projects

Interaction with staff and service quality on donor intention to donate

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59

Appendix 4 - Student projects 66

Slonim

Product usage: Blood product safety in massive transfusion recipients - Does

Prof Zsolt Balogh

white cell filtration really remove transfusion risk?

Donor behaviour: Emotional Psychology of Blood Donors

Dr Lisa Williams

Product development and storage: Biomimetic blood bag materials for prolonged

Prof John Whitelock, Dr Megan Lord, Dr Brooke

platelet storage

Farrugia

Product safety: Reducing the risk of TRALI

Prof Michael Reade

Donor Behaviour: multiple projects

A/Prof Barbara Masser (co-appointment)

Product safety: Inactivation of Zika virus in plasma and in platelet concentrates

Prof Roy Hall, Dr Jody Hobson Peters, Dr Daniel

following treatment with the THERAFLEX pathogen inactivation (PI) technologies

Watterson, Prof Paul Young

transfusion

Product safety: Exotic mosquito-borne virus threats to Australia (including WNV,

Prof. John Aaskov, Prof. Roy Hall (UQ), Dr

Product safety: Transfusion associated immunomodulation in a cohort of cardiac

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

Helle Bielefeldt-Ohman, Dr John Wright, Dr Jasimme Uddin

Mater Mothers’ Hospital Brisbane

Product usage: The incidence of microchimerism in paediatric patients

Dr Bryony Ross

Product safety: Reduction in anti-D immunoglobulin usage by genotyping: a cost

Dr Glen Gardener

(and) benefit analysis Orange Health Service

Product usage: Blood product safety in massive transfusion recipients - Does

Dr Doug Lenton, A/Prof Brian Burns

white cell filtration really remove transfusion risk? Prince Charles Hospital

Prince of Wales Hospital

Product safety: Reducing the risk of TRALI and Reducing the risks associated with Prof John Fraser and the Prince Charles Hospital Critical Care Research Group

patients – translating laboratory findings to a clinical context

Dr Rishendran Naidoo and Prof John Fraser

Product usage: An open label, single arm clinical trial assessing the safety and

Prof Minas Coroneo

efficacy of allogeneic 20% serum eye drops in severe dry eye patients

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

APPENDIX 5 COLLABORATIONS Royal North Shore Hospital

RESEARCH PROGRAM 2016-2017

Product usage: Blood product safety in massive transfusion recipients - Does

Dr Tony Joseph, Dr Mark Gillett, Dr Lesley Survela

Product safety: Red cell alloimmunisation: How can extended genotyping support

Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

Prof James Isbister, Dr Jennifer

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

Bowen, Dr Eleni Mayson

Appendix 3 - Abstracts accepted for oral or poster presentations 60 Appendix 4 - Student projects 66 Appendix 5 - Collaborations 70

Dr Chris Ward, Dr Lesley Survela

Royal Perth Hospital

Product development and storage: Development and characterisation of platelet

Royal Prince Alfred Hospital

Product safety: Reduction in anti-D immunoglobulin usage by genotyping: a cost

Dr Marian Sturm and Dr Leon Brownrigg

lysates

SA pathology

Product safety: Red cell alloimmunisation: How can extended genotyping support

A/Prof David Roxby

the ongoing transfusion needs of haemoglobinopathy patients?

RESEARCH INSTITUTES ARC Centre of Excellence for

Donor Health and Wellbeing: 45 and Up: Blood Service data linkage project: a

Mathematical & Statistical Frontiers

world-class donor health data-asset

Prof Louise Ryan

(ACEMS) Clin Prof Jonathan Hyett

Donor Health and Wellbeing: Safety and feasibility of first appointment

(and) benefit analysis

plasmapheresis donation

Product Safety: Non-invasive assessment (NIPA) translation: for high risk pregnant Clin Prof Jonathan Hyett

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

women who are allo-immunised to the RhD blood group antigen

Centre for Biopharmaceutical

Product development and storage: Development and characterisation of platelet

Dr Janet McPherson and

Innovation

lysate

Dr James Favaloro

Centre for Childrenâ&#x20AC;&#x2122;s Health

Product safety: Novel red blood cell targets for biopharmaceuticals

Professor Steven Mahler, Dr Xuan Bui

Product safety: Is parvovirus B19 a concern for blood safety in Australia?

Dr Sarah Tozer, Seweryn Bialasiewicz

Product safety: APPRISE partner

Prof Lyn Gilbert

Research St George Hospital

Product usage: Blood product safety in massive transfusion recipients - Does

Dr Mary Langcake

white cell filtration really remove transfusion risk? Sydney Eye Hospital

Product development and storage: Development and characterisation of platelet

Simon Cooper

lysate Westmead Hospital

Product usage: Blood product safety in massive transfusion recipients - Does

Mater Medical Research Institute

GOVERNMENT HEALTH DEPARTMENTS AND AGENCIES Product usage: Exploring the impact of blood transfusion on maternity outcomes

NSW

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

Westmead

Dr Jeremy Hsu, Dr Leonardo Pasalic

white cell filtration really remove transfusion risk?

Clinical Excellence Commission,

Centre for Infectious Diseases and Microbiology Laboratory Services,

Dr Amanda Thomson

Product Safety: Non-invasive assessment (NIPA) translation: for high risk pregnant Dr Glenn Gardener, Anne Tremellen women who are allo-immunised to the RhD blood group antigen

National Centre for Immunisation

Product safety: Q fever: how common is it, who is at risk and what does this mean Dr Nick Wood, Dr Helen Quinn,

Research and Surveillance

for blood safety?

Prof. Peter McIntyre

Perth Blood Institute

Product safety:red cell storage duration and procoagulant effects: Role of

Ross Baker and Quentin Hughes

microparticles and smaller particles

obstetric setting Hunter New England Health

Product safety: Q Fever: how common is it, who is at risk and what does this mean Prod David Durrheim

National Centre for Immunisation

Product safety: Q Fever: how common is it, who is at risk and what does this mean Dr NIck Wood, Dr Helen Quinn, Prof Peter

for blood safety?

Cassie Jansen, Brian Montgomery

obstetric setting patients

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59

Product safety: Transfusion Transmitted Infections and Emerging Risks Chikungunya and/or Zika virus emergence and establishment in Australia.

Product usage: Exploring the impact of blood transfusion on maternity outcomes

Product usage: The incidence of microchimerism in chronically transfused

Product safety: Q fever: how common is it, who is at risk and what does this mean Dr Penny Hutchison for blood safety?

Prof Chris Ward

the ongoing transfusion needs of haemoglobinopathy patients?

APPENDICES

Queensland Health

white cell filtration really remove transfusion risk?

Queensland Institute of Medical

Product safety: Detection of Ross River virus in Australian blood donations

Dr Natalie Prow

Product safety: Exotic mosquito-borne virus threats to Australia (including WNV,

Prof Andreas Suhrbier, Dr Greg Devine

Research-Berghofer Medical research institute

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

research and surveillance

for blood safety?

National Blood Transfusion

To review the use of O negative red cells, cryoprecipitate and washed cells

Product safety: Reduction in anti-D immunoglobulin usage by genotyping: a cost

Committee

nationally

(and) benefit analysis

NSW Office of Kids and Families

Product usage: Exploring the impact of blood transfusion on maternity outcomes and healthcare utilisation: informing the use of blood and blood products in the

McIntyre

Associate Professor Michael Nicholl

Save Sight Institute

Product usage: An open label, single arm clinical trial assessing the safety and

Dr Louisa Gordon Dr Con Petsoglou

efficacy of allogeneic 20% serum eye drops in severe dry eye patients

obstetric setting

CONTENTS Foreword 2 Message from the Chair and Chief Executive 4 Message from the Chief Medical Officer 5

THE YEAR IN REVIEW Working together to improve, build and grow 6 Measuring outcomes 8 Tracking our impact 10 Researchers 14 16 Meet our research leaders

APPENDIX 5 COLLABORATIONS Sax Institute

RESEARCH PROGRAM 2016-2017 Donor behaviour 20 26 Donor health and wellbeing Product development and storage 30 Product safety 36 Product usage 42

Donor Health and Wellbeing: 45 and up study: Blood Service data linkage project:

German Red Cross Blood Service,

Product safety: Inactivation of Zika virus in plasma and in platelet concentrates

a world-class donor health data-asset

NTSOB

following treatment with the THERAFLEX pathogen inactivation (PI) technologies

The Australian and New Zealand

Product usage: TRANSFUSE - Standard Issue Transfusion versus fresher red

Intensive Care Research Centre

blood cell use in intensive care - a randomised controlled trial

Prof DJ (Jamie) Cooper

The Kolling Institute, University of

Product usage: Exploring the impact of blood transfusion on maternity outcomes

A/Prof Jane Ford, Prof Jonathan Morris, Ms Jillian

Sydney

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

Patterson

McMaster University, Canada

Product usage: An open label, single arm clinical trial assessing the safety and

Theraflex UV-Platelets system in comparison to conventional platelet components New Zealand Blood Service

Dr Colin Chan

Appendix 2 - Grants active 2016-2017 58 - New grant applications: successful 59

Sanquin

CSL Grifols

Appendix 4 - Student projects 66 Appendix 5 - Collaborations 70

Prof Eric Delwart

Macopharma New Health Sciences Inc

Dr Souravi GHosh, Dr Adrian Zuercher and Dr

response in CIDP patients to promote cost-effective IVIg dosing.

Bradley Sedgmen Dr Jerry Holmberg

Product safety: Inactivation of Zika virus in plasma and in platelet concentrates

Dr Stefan Reichenberg, Dr Frank Tolksdorf, Dr

following treatment with the THERAFLEX pathogen inactivation (PI) technologies

Chryslain Sumian

Product development and storage: Anaerobic Red Cell storage

Dr Mireille Baart

Product development and storage: Use of additive solutions for reconstitution of

Environmental Research Institute

cryopreserved platelets

Scottish Blood Transfusion Service

Product development and storage: Use of additive solutions for reconstitution of

Dr Jia Lu Dr Juraj Petrik

cryopreserved platelets

Product usage:Validation of candidate immune biomarkers as predictors of IVIg Product safety: Does hepatitis E virus pose a risk to the Australian blood supply?

Donor health and wellbeing: Development of an Australian statistical model to

Singapore Defence Medical &

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

Dr Tatsuro Yoshida

Univeristy of British Columbia

Product development and storage: Pilot study to determine whether in vitro testing Dr Elisabeth Maurer can identify the best donors for our platelet components

University of Ohio

Donor behaviour: Pilot trial of an innovative online intervention with first time O

Prof Chris France

negative donors University of Ottawa

Product development and storage: Use of additive solutions for reconstitution of

Prof Robert Ben

cryopreserved platelets

INTERNATIONAL Alberta Health Service Canada

Appendix 3 - Abstracts accepted for oral or poster presentations 60

Product safety: Exotic mosquito-borne virus threats to Australia (including WNV,

Dr Darryl Crimmins

predict haemoglobin deferrals

INDUSTRY Blood Systems Research Institute

Product development and storage: Use of additive solutions for reconstitution of cryopreserved platelets

efficacy of allogeneic 20% serum eye drops in severe dry eye patients

APPENDICES

Nancy Heddle

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

obstetric setting Vision Eye Institute

Product usage: A Phase III prospective, randomised, double-blinded multicentre

Dr Ute Gravemann, Dr Axel Seltsam

Product safety: What is the risk of alloimmunisation by transfusion of variant RhD red blood cells that serotype as RhD Negative?

American Red Cross

Product safety: Does hepatitis E virus pose a risk to the Australian blood supply?

Dr Susan Stramer

Belgian Red Cross, Flanders

Product development and storage:Assessment of the thrombus formation rate

Hendrik Feys

of cryopreserved platelets Blood Systems Research Institute,

Product development and storage: Use of additive solutions for reconstitution of

USA

cryopreserved platelets

Dr Larry Dumont

Product development and storage: Assessment of the thrombus formation rate of cryopreserved platelets Canadian Blood Services

Product development and storage: Characterisation of cryopreserved platelets

Dr Peter Schubert, Dr Dana Devine

Product development and storage: Use of additive solutions for reconstitution of

Dr Jason Acker

platelets

Environmental Protection Authority,

Product safety: What is the risk of alloimmunisation by transfusion of variant RhD

New Zealand

red blood cells that serotype as RhD Negative?

Fiji National Blood Service of the

Product safety: Building Capacity to solve complex red cell serology using genetic

Republic of Fiji Islands Ministry of

sequencing

Dr Stacy Scott Adriu Sepeti

Health