Posted on Aug. 12: Solving the mysteries of blood transfusion allergies
[img_inline align=”right” src=”http://padnws01.mcmaster.ca/images/Nancy_Heddle.jpg” caption=”Nancy Heddle”]Improving patient care by solving a decades-old blood transfusion allergy mystery was one career highlight for Prof. Nancy Heddle. That work, along with her other research projects in blood transfusions and blood products, led to another career high early this year when the professor in the Department of Medicine and director of the Transfusion Research Program at McMaster received the 2002 Premier's Award of Excellence.
Heddle was one of six recipients of this year's award presented by Ontario Premier Ernie Eves at a Toronto reception. The annual awards recognize career success and community contributions of college graduates. Her award was in the Health Sciences category.
“It was absolutely wonderful,” says Heddle, a 1969 graduate of the Medical Laboratory Technology Program at Mohawk College. She received a medal and certificate as well as a $5,000 bursary to be presented to the college. “I was excited, and honoured that I had been chosen.”
Her earlier work helped to solve a 30-year-old puzzle about why almost four out of 10 patients suffered allergic reactions when receiving blood transfusions. She published a paper in 1994 in the New England Journal of Medicine that showed how to prevent allergic reactions by separating plasma from blood platelets before transfusing them or by removing white cells before storing blood products.
Routine use of special filters to remove white cells before storage means that now only about 1-2 per cent of patients suffers an allergic reaction. “That was a major impact,” says Heddle.
“People like Nancy don't come along every day. She's somebody who's really made a difference. The fact that what she does saves lives makes her stand out above the crowd,” says Rose Charmee, manager, alumni relations, for Mohawk College.
The college nominated graduates in four categories this year among a total of 83 nominations from all colleges across the province. This was the fifth award for Mohawk and the first in the health sciences category.
Looking ahead, Heddle now hopes to land another award this time in the form of funding for a proposed database that would track blood products collected and used throughout the province. No such central information bank exists right now, although individual hospitals keep track of their use of blood products.
“The province has no idea where blood products are or what they're used for,” says Heddle. She says the Krever report on HIV/AIDS infection found that it had been a nightmarish task to track down blood donors and recipients through individual hospitals during the 1980s.
Having been turned down for funding this year from the Canada Foundation for Innovation, she hopes to obtain money from the Ontario Ministry of Health to begin the project through a handful of hospitals, beginning with Hamilton and London. Ideally, the proposed utilization database called TRUST, or Transfusion Registry for Utilization, Surveillance and Tracking would be the beginning of a provincial or even national bank of comprehensive information about every transfusion.
Knowing more about where and how blood is being used would help the ministry better control costs, she says, not to mention allowing health authorities to act more quickly in the event of another viral or blood-borne disease outbreak.
“Canadian Blood Services is very interested in working with us,” she says, explaining that the agency needs to refine its forecasts for demand for blood products.
Individual hospitals might use such a database to better compare use of blood products for such surgeries as hip replacements and identify inefficiencies.
Having large databases tied to health outcomes also benefits transfusion medicine researchers such as Heddle, whose work links clinical issues with public policy. She studies transfusion practices in hematology and oncology patients, including allergic reactions; lab practices, including the use of standards in transfusions; and how to improve the workings of hospital transfusion committees.
Although every hospital is supposed to have a transfusion committee another Krever recommendation a recent survey she undertook found that only about half of Ontario's hospitals follow that practice. “We're hoping through the research group to make it much easier to form these committees,” particularly for small hospitals that typically lack transfusion expertise.
Heddle has been working in Hamilton since 1975, beginning in the transfusion medicine service initially for Chedoke McMaster Hospitals, then for Hamilton Health Sciences. In 1999, she became manager of transfusion medicine for the Hamilton Regional Laboratory Medicine Program. Two years later, she joined McMaster as director of the new Transfusion Research Program, a joint initiative involving McMaster and Canadian Blood Services. “For 20 to 25 years, McMaster has probably had the key people in Canada who have been leaders in transfusion medicine,” she says, referring to work by Prof. John Kelton, now vice-president of the Faculty of Health Science.
In 1992, Heddle completed a master's in health research methodology through the Department of Clinical Epidemiology and Biostatistics.
She belongs to a group of researchers called BEST (Biomedical Excellence for Safer Transfusions), which is part of the International Society of Blood Transfusion.
Although she studied in Hamilton more than three decades ago, she says it was mostly by accident that she landed work here.
Among her early stints after graduating from Mohawk, she volunteered at the New York Blood Centre, where she worked with one of the most prominent transfusion specialists then in the United States (she had followed her husband, Dr. Stewart Heddle, a plastic surgeon then training in New York).
It was during their subsequent stint in Iran, where her husband worked at a hospital in Tehran, that she received a life-changing telegram. “I got a job at McMaster while I was a lady of leisure in Iran.”
This story originally appeared in the April issue of the McMaster Review
Photo credit: Chantall Van Raay
