Canadian Blood Services (French: Société canadienne du sang) is a non-profit charitable organization that is independent from the Canadian government. The Canadian Blood Services was established as Canada's blood authority in all provinces and territories except for Quebec in 1998. The federal, provincial and territorial governments created the Canadian Blood Services through a memorandum of understanding.

Canadian Blood Services is a health-care system that is part of Canada's broader network of systems, and it is currently the only organization that is funded by Canada's provincial and territorial governments for manufacturing biological products. The two organizations work closely to share blood products in times of need and collaborate regularly to share information, insights and data.

There are several reasons why individuals can be deferred from donating blood, including intravenous drug use, living in the UK for certain periods of time, coming from an HIV-endemic country, and engaging in activities that confer a high risk of HIV.

Canadian Blood Services has been criticized for moving away from an unpaid voluntary donor model towards a commercial model based on monetary incentives for donation.

Blood testing

Canadian Blood Services has a multi-tiered system to measure the safety of their blood supply. Before donating, donors are first screened for their health.

  • Making sure the donor is healthy by asking if they have the flu, sore throat, fever or infection
  • What medications the donor is taking
  • If they have had a vaccination within the last three months
  • Questions about their medical history
  • Questions about their travel history
  • Questions about their lifestyle

Once the blood is donated, it must then go through testing for infectious diseases, including but not limited to HIV and hepatitis. Blood is also surveyed to monitor transmittable diseases in blood donors, investigated for possible transfusion-transmitted infections in blood recipients, and scanned for potential emerging pathogens that may pose a risk in the present or future. These policies were introduced after the emergence of several reported cases of severe immune deficiency among gay men in the United States at the end of 1981. In June 1982, an increase in the cases of immune deficiency was reported among several groups of gay men in Southern California. Furthermore, because many thought that the immune deficiency was only prevalent among gay men, the disease was initially called Gay-Related Immune Deficiency (or GRID). Hence, in the mid-1980s, the predecessor of the Canadian Blood Services—the Canadian Red Cross Blood Transfusion Service—introduced a blood donor restriction on men who have had sex with men (MSM) as of 1977, on the grounds of protecting the blood supply from HIV infection.

In 2006, Canadian Blood Services began conducting a thorough review of the blood donor restrictions on MSM; however, in 2007, the board of directors concluded that the restrictions were to be maintained. The new policy came into effect on July 22, 2013. In 2019, Canadian Blood Services amended their policy again, after Health Canada had approved their request to reduce the waiting period for MSM donors from one year to three months. Canadian Blood Services plans to remove the ban by the end of 2021.

In April 2022, the Canadian Blood Services announced that by September 30, 2022, the 3-month deferral period would be scrapped and replaced with a policy inquiring if donors engage in any higher-risk sexual behaviours, regardless of sexuality. Monogamous individuals would be able to donate blood without any waiting period whatsoever. The UK has a similar blood donation rules implemented in 2021.

On September 11, 2022, this new sexual behaviour-based screening was implemented for all donors, regardless of gender or sexual orientation. The previous questions regarding MSM were replaced by two new questions. The first asks whether the donor had a new sexual partner in the last 3 months, and the second, whether they had more than one sexual partner in the same period. If the answer is yes to any of the two questions, then there is a follow-up that asks whether they had anal sex in the same period. If they have, then a 3-month deferral period is required. Eligibility is determined by the most current evidence-based research available. If a gay man is having unprotected anal sex in a committed monogamous relationship, they are less likely to be HIV positive than a man with secondary sex partners. All donations go through HIV testing and the approximate nine-day window where HIV goes undetected is the same for a gay man and a heterosexual man. This program is funded by contributions from Health Canada, which has made a $3-million investment in the research program. The MSM Research Grant program is anticipated to help evolve and inform the current eligibility criteria for MSM, while maintaining and ensuring the safety of the Canadian blood supply.

Blood donation from trans individuals

Previously, there was ambiguity regarding the screening process for trans donors before the national criteria were implemented. On August 15, 2016, Canadian Blood Services' new eligibility criteria for transgender people came into effect. According to these criteria:

  • Donors who have had lower gender affirming surgery will be deferred from donating blood for three months after their surgery. They will then be screened in their affirmed gender after three months.
  • Donors who have not had lower gender affirming surgery will be asked questions based on their sex assigned at birth and will be eligible to donate or be deferred based on these criteria. Canadian Blood Services' two main risk factors for trans donors include:
  • Risk of Transfusion-related acute lung injury (TRALI), particularly from trans men. It is more likely for donors who have had pregnancies in the past to have antibodies present in their blood plasma that can cause TRALI in a recipient, which is rare but potentially fatal. In order to reduce this risk, instead of transfusing plasma protein from donors at risk for TRALI directly to patients, their plasma are used to produce plasma protein products.

Services offered

The Canadian Blood Services provides services in four main areas: blood, plasma, stem cells, and organs and tissues.

Whole blood collection is the shortest process of those listed above and at over 850,000 units collected per year, is the primary blood collection service offered by Canadian Blood Services. About 450 mL (1 United States liquid pint) of blood is collected during a blood donation. For a typical donor this represents about ten percent of their total blood supply.

thumb|350px|Canadian Blood Services in [[Brampton, Ontario. This donor centre is dedicated to plasma donation only.]]

Blood

The Canadian Blood Services collects, tests, and manufactures blood and blood products. Canadian Blood Services also work in conjunction with provincial and territorial governments throughout Canada to meet the needs of patients throughout the country. As of 2019, there is not enough plasma collected in Canada to meet the demands of the country. The amount of plasma that the Canadian Blood Services collects only meets 13-14% of the demand for immune globulin. Manufacturing of stem cells is done through the collection of cord blood, to then be put in the cord blood bank. Canadian Blood Services also operates a national registry of potential adult stem cell donors, which is part of a network of other international donor registries. Human leukocyte antigen typing is also a service provided to assure that the matches between donors and receivers of stem cells are the best as possible.

Cord Blood Bank

Cord blood is the blood remaining in the umbilical cord and placenta after a baby is delivered. Cord blood contains an abundance of stem cells, and is capable of treating several genetic diseases, blood disorders, and immune deficiencies. It is useful in the treatment of over eighty diseases ad disorders, some of which include leukaemia, lymphoma, and sickle cell disease. After transplantation, donated stem cells that are deemed healthy replace damaged stem cells in a patient's bone marrow and immune system. From this pledge, the Canadian Blood Services underwent its first fundraising campaign For All Canadians, through which they obtained over $12.5 million, exceeding their initial goal. As of 2019, only thirty-one percent of the roughly 440,000 donors in Canada's stem cell registry are ethnically diverse—a figure that decreases to only three percent when examining those who are of mixed race.

Organs and tissues

The Canadian Blood Services works closely with the Organ and Tissue Donation & Transplantation community to help facilitate inter-provincial organ sharing, and to improve national system performance in this area. This is done via the provision of professional education resources, the development and sharing of leading practices, increasing public awareness, and through data analysis and reporting.

Since 2008, the federal, provincial, and territorial governments have invested more than $70-million to support the Canadian Blood Services and their work with the organ and tissue donation and transplantation system. The kidney paired donation program is operated collaboratively between Canadian Blood Services and Canada's living kidney donation and kidney transplant programs. Usually, donors wish to donate to a friend or family member if they are compatible, in which case the kidney paired donation program is not used. However, if they do not have a patient in mind to donate to, the kidney paired donation program can be used. Those who are waiting for a kidney transplant make up approximately 78% of the organ transplant waiting list.