QHS New Researcher: Meet Dr. Jeannie Callum
Dr. Callum is a professor of pathology and molecular medicine and is director of transfusion medicine at Queen’s University.
Can you provide a brief summary of your research?
I co-lead a large group of twelve Kingston and Toronto-based researchers in transfusion medicine called the QUEST research team. It's not a huge discipline; we're a niche subspecialty of hematology. I focus mostly on discerning the right bleeding transfusion recipe to stop bleeding. During the pandemic we ran a large multicenter international randomized trial of convalescent plasma versus standard of care to determine whether convalescent plasma would stop people going to the ICU on a ventilator or dying. It turned out to be ineffective—receiving convalescent plasma, particularly with poor antibody profile, is more detrimental than receiving none. This is an important development in our field.
What problem do you want to solve through your research?
The primary thing I'm trying to do is figure out how we can stop using frozen plasma. Frozen plasma is an extremely dilute blood product. It's not processed at all and is thus not virally inactivated, putting patients at risk for bloodborne pathogens and some transfusion adverse reactions. Another issue is the over-prescription of blood. For instance, if someone has a postpartum hemorrhage or major trauma, patients often end up in the intensive care due to fluid overload which causes difficulty breathing. They survive, but if we could find a method of providing a concentrated dose of clotting factors instead of liters of fluid for every dose of clotting factors, it might improve patient care.
Why is your research important to you?
Quality of care is always paramount and accomplishing this often means conducting research. For example, until two years ago when we replaced clotting factor I (called fibrinogen), we used to use a blood component called cryoprecipitate, but every time you got a dose of cryoprecipitate, you got 10 donor exposures and most patients would get one to five doses of this so they would get 10 to 50 donor exposures just for replacing one clotting factor. We found that a potentially safer product existed in Europe and decided to conduct a Canadian trial in eleven hospitals and found it be both safe and effective. The country rapidly switched to using the new product, preventing our patients from unnecessary exposure to viruses and bacteria.
What do you hope to learn from your research?
For each product it's different. More than anything, my team and I are here to improve blood transfusion by any means we can. Canadian Blood Services ensures the product is safe, but then it is the hospital-clinicians who are tasked with ensuring it gets to the right patient safely, in the right dosage, and at the right time. Our research helps them do this more effectively and safely. We have just completed a multi-centre audit of the use of plasma to help inform how we work to improve the use of this blood component.
What kind of impact do you hope that your research will have?
The greatest impact I'm hoping for is that transfusion care becomes safer for patients. Another goal is that we can help trauma bay doctors by making hemorrhage treatment methods easier and more convenient for all involved. Ideally, we will get to a point where our hospitals run like NASCAR pit stops; they bring the car in and in seconds they change all the tires, fill up the engine, clean the windshield, and the tires never fall out. We want to speed up the delivery of care to patients, ensure every patient gets high quality blood product support, and reduce the complexity for the clinicians caring for these patients.