On the Shoulders of Giants

SIXTY YEARS AGO, Dr. James Yant and other physicians of the Sacramento Society for Medical Improvement (SSMI) recognized the need for a community blood program and forged the initial elements of what we know today as BloodSource. As with many other innovative and community-centered programs the Medical Society founded, BloodSource was a bold step into the future of medicine.

From its humble, albeit very visible, beginnings under the water tower on J Street to today's international programs and respected reputation as a transfusion medicine leader, BloodSource most certainly exceeded the founders' expectations. Today, BloodSource provides service to major healthcare systems in Northern and Central California and routinely supplies blood and components to hospitals and patients across the nation when there is a need.

BloodSource's leadership has been visionary from the beginning. Establishing best practices in transfusion medicine was the focus of our founders. They held scientific workshops and seminars for the leadership of state and national blood banking organizations, which were just opening up their own transfusion medicine practices.

Medical direction has been a critical factor in the success and growth of BloodSource. From Dr. Yant's and his colleagues' tenure to the full-time medical directors of today, BloodSource has been recognized for quality and innovation.

Dr. E.J. Watson-Williams, Scientific Director, was a champion of component therapy, which was a tremendous advancement allowing the support of numerous patients from one unit of blood.

Dr. Vincent Caggiano brought the insight of the clinician to our blood center. His understanding of the need and use of blood and components in patient care, and his view of transfusion medicine through the lens of a physician with experience in the clinical setting, was instrumental in establishing long-standing and positive relationships with hospitals and physicians throughout Northern and Central California.

Through his research experience and knowledge of hepatitis, Dr. Paul Holland, Medical Director and CEO from 1983 to 2004, implemented new blood safety screening tests. Those tests provided a significant margin of safety in the initial response to the AIDS crisis. His leadership guided BloodSource through that most critical period in transfusion medicine.

Dr. Patricia Kopko is Executive Vice President, Medical Affairs and Histocompatibility Lab Director. Her investigations of Transfusion Related Acute Lung Injury (TRALI), funded by a National Blood Foundation grant, resulted in increased understanding of TRALI that redefined the collection and transfusion of plasma. Dr. Kopko is recognized as a leading expert in the field of transfusion medicine and histocompatibility. Her efforts have led to improved blood safety and care of patients who receive transfusions and transplants.

The development of one of the nation's first blood banking computer software systems started at BloodSource in the mid-1970s. In the 1970s, BloodSource was one of the first blood centers to bring automation to the donation process. We pioneered the use of apheresis machines to collect specific components from donors. Our ability to consistently collect blood components has made BloodSource an international leader in automated collections today.

Education has been a core commitment of our organization. BloodSource established a "Specialist in Blood Banking" (SBB) School in 1978. Approximately 25 students have now graduated from the SBB School and bring their special skills to blood centers and hospitals across the country.

This successful educational experiment was the forerunner of BloodSource establishing programs in HLA and Immunohematology. Today's Clinical Histocompatibility Scientist (CHS) and Clinical Immunohematology Scientist (CIS) programs are the first of their kind in U.S. blood centers. Students with an undergraduate degree in science enter a year-long program to learn the specific science of CHS or CIS work in preparation for national or state exams. To date, eight BloodSource employees have completed the CHS program, passed their national exam and earned state certification; another employee has begun studies. One employee has concluded her year in the CIS program and another has begun studies. These programs help supply the professional staff needed in our BloodSource labs and will continue to do so into the future.

BloodSource works closely with college and universities in Northern and Central California to develop programs that will focus student interest on transfusion medicine. We look forward to the day when transfusion medicine specialty programs in medical and nursing schools will bring students into the blood banking environment.

Now in our 60th year, BloodSource is moving operations for only the third time in our history. Twenty-four years ago the BloodSource Board of Directors purchased property on Stockton Boulevard in Sacramento. Little could they know the decision to enhance operations in 1984 would provide a legacy redeemable in 2008 to further expand the growth of quality services. That critical decision 24 years ago has provided the financial foundation to build new state-of-the-art blood testing laboratories including new homes for our world-recognized HLA and Reference Labs.

Additionally, BloodSource will occupy a 95,000 square foot building across a parking lot from our new labs. This building will house administrative operations, Donor Recruitment, a donor collection site, autologous center, therapeutics apheresis suite, Public Affairs, Marketing, IT, Accounting and Human Resources. These facilities should provide the necessary physical plant for several decades to come - our new legacy, a far cry from the $1 per year space "under the water tower."

What does the SSVMS's 1948 initiative look like today? BloodSource employs more than 625 people who ensure blood, components and services are available when patients need them. BloodSource labs perform more than three million tests annually. A projected 225,000 donors will be drawn this year and, from this base, almost 1 million components will be produced to transfuse patients. The $80 million budget supports these and all of the other activities of BloodSource, including a volunteer program that boasts more than 1,000 volunteers.

Several BloodSource programs are internationally recognized. Mentioned earlier, our Histocompatibility Lab provides transplantation support locally and around the globe. Recently Dr. Kopko, working with Kathie Nelson, our 30-year department Director, and with transplant teams, established a new protocol allowing several patients to benefit from incompatible organs.

Through a federally funded grant, Dr. Christopher Gresens, VP and Medical Director, Clinical Services, has extended BloodSource programs to Guyana, Mozambique, Tanzania, Kenya and Rwanda, as part of a national effort to enhance transfusion medicine operations around the world. He has helped nations such as Georgia, formerly a part of the Soviet Union, upgrade their blood banking operations.

Our administrative relationships include creating a new business model to increase the collection of plasma for fractionation with a biotech company in Austria because new treatments for immunodeficient patients have increased worldwide demand. As our founders would expect, BloodSource is again a pioneer and leading efforts to ensure availability to all in need.

Why does BloodSource consistently occupy a leadership role in the transfusion medicine community? I am reminded of the story of Sir Isaac Newton, when asked why he thought he was able to see so far into the scientific future. He paused and explained, "I am able to see these things because I stand on the shoulders of giants."

BloodSource is able to provide leadership today and will do so into the future of transfusion medicine because, like Newton, we stand on the shoulders of giants - women and men, physicians of our Sierra Sacramento Valley Medical Society, who for 60 years have provided BloodSource with a strong foundation and a clear view into the future based on a dedication and commitment to our broader community.

At the end of our 60th anniversary year, the amount of blood and components collected in the last 60 years would actually fill the J Street water tower - 3.3 million gallons!

We have come a very long way since those humble beginnings on J Street. And when we review our accomplishments at the next anniversary, our greatest compliment will be that we made it here because we stood on the shoulders of giants, today's physicians of the SSVMS and a dedicated BloodSource staff.

For 60 years of vision, leadership, support and dedication, a sincere and hearty thank you.

mike.fuller@bloodsource.org