Veterinary Blood Banks Keep Supplies Flowing

Veterinary Blood Banks Keep Supplies Flowing Veterinary Blood Banks Keep Supplies Flowing cover storiesThe history of veterinary blood banking only reaches back a couple of decades.The history of veterinary blood banking only reaches back a couple of decades.veterinary blood banking, veterinary blood banks, blood banks, pet blood bankLori Luechtefeld
For Veterinary Practice News

The history of veterinary blood banking only reaches back a couple of decades. But in that time, it has grown substantially and matured quickly. Today, thousands of veterinarians nationwide rely on commercial and nonprofit blood banks for their transfusion needs.

"Given the level of animal care and increasing technology and therapy options, the demand for animal blood products has risen significantly," says Ron Harrison, DVM, co-owner of the Veterinarians' Blood Bank Inc. in Vallonia, Ind. In particular, Dr. Harrison says, his facility has seen a dramatic increase in the demand for feline blood products.

Mark Ziller, president of the Pet Blood Bank in Lago Vista, Texas, says the veterinary blood banking industry continues to gain momentum among both specialists and general practitioners.

"In part this can be attributed to the increased availability of blood products, which has resulted from both the growth of existing blood banks and the emergence of several new commercial blood banks," he says. "Additionally, more and more veterinarians are gaining exposure to blood banking in veterinary schools and continuing education seminars."

Rebecca Nusbaum, CVT, VTS (ECC), director and donor coordinator at HemoSolutions in Colorado Springs, Colo., says that as pet owners become more aggressive in seeking treatment for their pets, more veterinarians are faced with the need to practice transfusion medicine.

And as a result, the number of practitioners turning to blood banks for their supplies continues to grow.

However, many veterinarians still rely on more traditional means of procuring needed blood.

"A lot of older veterinarians still use employee-owned animals as donors," Nusbaum says. "The problem is that these animals have most likely not been typed for their specific dog erythrocyte antigen and have not been screened for blood-borne pathogens or parasites."

Strength in Numbers
One of the most noteworthy changes within the veterinary blood-banking industry is the rise in the number of veterinary blood banks around the country.

Anne Hale, DVM, owner and director of Midwest Animal Blood Services Inc. in Stockbridge, Mich., says that there is now at least one functioning veterinary blood bank in every region of the U.S.

"This has provided the field practitioner with a larger number of choices when selecting blood products for patients," she says.

Sun States Animal Blood Bank in Wilton Manors, Fla., is a testament to the growing demand for veterinary blood banking facilities. In October, the nonprofit organization opened a new branch in Jensen Beach, Fla.

"As standards and procedures are identical between both operations, we are able to provide completely interchangeable products, as well as improved coverage in both regions," says Larry DeLuca, EdD, MD, president and director of Sun States. "There is at least one other branch expected to open in 2008, and we are at work making it possible for other blood banks to join us under the nonprofit umbrella."

Rising Component Use
Recent years have seen a gradual shift in the types of blood products supplied to practitioners, Hale says.

"Components—or separated blood products—now make up approximately 40 percent of the transfusion product utilized in transfusion medicine today," she says. "Just 10 years ago, components made up only 10 percent of the product used. Our goal as transfusion medicine practitioners is to have 80 percent reflect component use and 20 percent whole blood use."

Nusbaum says many veterinarians operate under misconceptions about whole blood, which is not the solution to most transfusion situations. Component therapy is considered the standard of care—meaning veterinarians should administer only the component the patient needs.

"A unit of blood can be processed into many products, such as packed red-blood cells, fresh frozen plasma, frozen plasma, cryoprecipitate, cryosupernate and even platelet-rich," Nusbaum says. "This is the most resourceful way to utilize donors and treat patients."

Leslie Grimes, blood bank administrator at Hemopet in Garden Grove, Calif., agrees.

"More veterinarians are using canine blood component products than before, especially with fresh frozen plasma being used for therapy of infectious diseases such as parvovirus or to provide passive immunity in orphan puppies," she says. "The positive clinical response to this treatment is just amazing."

The Next Generation
As in human medicine, new scientific findings continue to shape products and practices in the veterinary blood banking industry. Over the past couple of years, there have been two notable changes, says Hemopet president W. Jean Dodds, DVM.

"First, Hemopet—and presumably the other pet blood banks—now also screen their blood donors for Mycoplasma organisms that can be transmitted by blood products (Mycoplasma haemocanis and Mycoplasma haemominutum) using DNA PCR technology," Dr. Dodds says.

"The second potentially important finding was the recently published studies in the human blood banking industry showing that red blood cells lose their nitrous oxide content upon storage, which reduces their physiological activity," she adds.

"Adding back nitrous oxide restored the full activity of these red blood cells. The potential benefit of applying this knowledge to improving the viability of stored animal blood cells is important."

In addition, Hale says that veterinary blood banks are exploring the next generation of products to help patients.

"Stem cells and cord stem cells have been successfully collected utilizing apheresis technology," she says. "This allows oncologists to better utilize chemotherapy and treat many bone marrow–related cancers."

"A unit of blood can be processed into many products, such as packed red-blood cells, fresh frozen plasma, frozen plasma, cryoprecipitate, cryosupernate and even platelet-rich."

Hale says that platelet concentrates have been used for their ability to accelerate healing of chronic tendon injury in horses and dogs. In addition, she says continued improvements in infectious disease identification have enabled blood banks to more effectively screen transfusion products and protect patients from disease transmission during transfusion.

"New-generation pathogen-inactivation technologies have been utilized in the dog as a part of early FDA preclinical trials that indicate we can utilize this technology to provide safe transfusion product with minimal risk of infectious disease transfer," she says.

The Regulatory Landscape
The veterinary blood banking industry remains loosely regulated. The USDA and FDA continue to allow blood banking without direct supervision, and, to date, California is still the only state regulating blood banking in animals, Hale says.

"It is likely that when and if the federal government chooses to regulate veterinary blood banking, the FDA Center for Veterinary Medicine will provide the oversight," Hale says. "Currently, they are reluctant to register blood banks for inspection and review unless a new-drug claim is pursued. Blood-bank products with specific immunological claims, such as equine hyperimmunized plasma, are overseen and licensed by the USDA Center of Veterinary Biologics."

In California, veterinary blood banks are overseen by the state  Department of Food and Agriculture and are required to maintain their own donor populations. The oversight was put in place by a 2002 piece of legislation that Dr. DeLuca at Sun States calls "misguided."

"Largely the product of special-interest lobbying of the Legislature, the bill essentially outlaws community donor programs in the state of California, and prohibits programs that are community-based from shipping into California," he says.

In 2006, partly in response to the California regulation, Sun States published an article in the Journal of Applied Animal Welfare Science that demonstrated that community-based donor programs can be safely and effectively implemented.

"We felt it was important to set the record straight, and to do so in a scientifically rigorous fashion," DeLuca says.

Developing Standards
In lieu of formal regulation, two associations have turned their attention to developing standards for the veterinary blood banking industry.

The Association of Veterinary Hematology and Transfusion Medicine, formed in 1991, is in the final revisions of a standards document, Hale says. Meanwhile, the American Assn. of Veterinary Blood Banks, formed four years ago, has developed a basic standards document that is now in its second revision, she adds.

"[Both groups] have agreed to meet and review the documents so that veterinary blood banks do not have trouble complying with both documents," Hale says. "AVHTM's document will likely be a technical manual with strong scientific explanation for many aspects of veterinary transfusion medicine. AAVBB's standards are designed to provide a basic description of blood banking practice and compliance."

Nusbaum, secretary and treasurer for AAVBB, says that many veterinary blood banks are members of both AAVBB and AVHTM, and several people sit on committees of both organizations.

She says that in the future, AAVBB will operate a committee that will conduct on-site inspections of blood banking facilities that want to acquire voluntary accreditation under the organization.

Patricia Kaufman, director of Animal Blood Bank Inc., says the AAVBB standards were developed using the human blood banking standards developed by the American Assn. of Blood Banks as a guide.

"As an industry, we're moving closer and closer to following the same guidelines as in human blood banking," she says. "We continue to tighten our protocols."

And while the American veterinary blood banking industry continues to become more refined, other countries are beginning to take note.

"The biggest change we've seen in the past few years is that interest in veterinary transfusion medicine has gone worldwide," Kaufman says. In Europe, for example, animal-rights laws were recently altered to permit the practice of animal blood banking.

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