October 12, 2023
Member Spotlight: San Diego Blood Bank
San Diego Blood Bank Launches New Program to Match Donor Samples to Patients with Sharper Precision
Doug Morton wants your blood.
No, he’s not a vampire, although amassing blood is a part of his job. As CEO of San Diego Blood Bank, Doug works with the organization to raise awareness about the need for blood donations throughout Southern California and why it’s critical that the donor pool is diversified to include more people of color and those who have rare blood types. You might be considered to have a rare blood type and not be aware of it, and a new program using a laboratory-developed test can identify rare blood donors more accurately.
Called Precision Blood, machine learning and AI is incorporated in analyzing blood samples to find matches between donors and patients that are much more precise beyond the eight blood type groups that most of us are familiar with. There are actually more than 30 blood groups with hundreds of different antigens that could lead to different health outcomes for patients—especially those who rely on regular transfusions—which Precision Blood can detect. As part of the initiative, San Diego Blood Bank is partnering with Rady Children’s Hospital-San Diego on a clinical trial to compare outcomes in patients transfused with standard blood services and those transfused with Precision Blood.
Read on to learn more about the unique program and why you should consider donating. With Halloween just around the corner, Doug says this is a festive time to donate as they lean into a vampire theme in the décor at their headquarters and mobile blood drives.
Congratulations on being named CEO of San Diego Blood Bank. While you’ve held many leadership positions at the organization, what has changed for you since the title became official in spring 2022?
I’ve been at San Diego Blood Bank since 2000. I came as director of IT and have been working in operations as COO since 2005. Mostly what’s changed is there’s much more interaction with the board—committee meetings and that sort of thing. I really like to stay connected to our daily operations and working directly with our leadership team, but I certainly have needed to take some time away to do some visioning as we look to the future and consider how we address upcoming challenges and future innovations.
What attracted you to the nonprofit world, and specifically an organization tied to public health and life science?
Previously, I was working at a construction materials company—so this was quite a change in terms of industry! I wanted something with purpose and that was mission-driven, and I was specifically considering healthcare, but I didn’t have a background in healthcare. An opportunity came up at the blood center for a director of IT and I thought it would be a great chance to use my skillset on the computer science side and start breaking into the field. At the time, I thought that I’d stay for a few years and then maybe move to a hospital setting. But I really fell in love with blood banking, and it’s been a tremendous place to work. The community of volunteers, blood donors, financial donors, and a wonderful employee base is why I’ve stayed all these years.
Give us an overview of the Precision Blood Initiative and how you have partnered with Rady Children’s Hospital-San Diego on the next phase of the program. Is this program unique within blood banking on a national scale?
To my knowledge, yes, this specific partnership is very unique. We talked about my computer science background, and it’s interesting that we’ve come full circle because part of the Precision Blood Initiative involves machine learning and big data. For Rady’s specifically, the ideas around precision blood is ‘can we better match patients with donors?’ This conversation started with some of our routinely transfused patients at Rady Children’s Hospital-San Diego, and thinking about how we can ensure that they don’t develop antibodies and have problems with the transfusions. We just had a patient at Rady’s, Kamila, receive her 164th transfusion. Children like Kamila have conditions such as beta thalassemia [an inherited blood disorder] and will require transfusions for life until a cure is found.
Why do we need donor-and-patient matching that is more precise than what is widely available today?
Our vision for Precision Blood is that it ultimately becomes the standard of transfusion medicine. And we’re prophylactically matching to give the best available match for any patient.
When it comes to blood types, most people know about the ABO blood group and the antigens that create A, B, O and AB blood types. Typically, people also know about the Rh group—the key antigen there is the D antigen, which creates the negative or positive of those four blood types. But there are 34 additional blood groups in addition to ABO and Rh. And each of those blood groups have multiple antigens—we end up with more than 300 antigens and 36 blood groups. What we’re doing with Rady’s is starting with frequently transfused patients.
When a patient like Kamila is receiving transfusions often, that blood usually comes from multiple donors. You can imagine the number of different antigens that the patient is exposed to over time. Our goal is to minimize those conflicts, and specifically, the study with Rady’s is to understand the health outcomes. There have been some studies, for example, with sickle cell patients who receive multiple transfusions that indicate antigen mismatching is a problem. We’re looking to initially do better matches for frequently transfused patients, and that’s what this study is going to show us. Does this [precision matching] lead to better red cell transfusions and fewer complications like headaches or fevers?
I’ve been here for 23 years, and I’ve never regretted coming to work. There’s a tremendous reward for getting into a field where you know you’re going to help people, whether it’s on the front lines or the back end. What you’re doing at work and why you’re doing it matters.
What are the AI and machine learning components of Precision Blood matching?
We’re in the process of building out a precision blood lab. Increasing the number of runs [on the donated blood] allows us to increase both the number of patients that can be sampled as well as the number of donors. This is one of the reasons we’re looking for philanthropic support—to expand this so we can scale.
Our computer system flags donors for antigens that appear in less than 3 percent of the population—that’s considered rare. Our lab team gets a note when a unit comes in that’s considered rare and they can set that aside for a specific patient in need. We might freeze those units, and those rare red cells could be frozen for up to 10 years.
Where we’re utilizing the machine learning is on the algorithm of matching. The current technology is serologically manually testing for antigens. The reason why this hasn’t been done previously is it’s too time consuming and expensive to be able to test all these individual antigens using reagents. Next-generation sequencing allows us to look at the DNA and predict all those 300-plus antigens. In the same way, it would be very difficult for a human to look at 300 antigens and a list of donors and try to find who the proper match is. We’re using machine learning and algorithms to more precisely identify those donors—we can identify units in inventory, in progress or in manufacturing [the blood is being processed and pending centrifugation, separation and testing] that are a match or donors that match.
The latest stats provided by the Blood Bank on donor demographics show only 1.9 percent of donors are Black, 15 percent are Hispanic/Latino, 7.9 percent are Asian and Pacific Islander, and 0.4 percent are Native American. Why is it so important to have a more diverse donor pool?
There is a health equity element to this. If we pull a red cell off the shelf using standard of care—which is we match blood types and look for a few antigens that we know are problematic—if you are a minority, there’s a much higher chance that you’re going to get a mismatch on some of these other antigens simply because of the odds that the blood came from a Caucasian donor. And these antigens tend to follow genetics. If we want to give you the best possible match, we want to use Precision Blood to look for that match.
Secondarily, we need to have a very diverse donor population so that our likelihood of finding a match improves. And that’s the message we’re trying to get out: you need to donate for your community, because a patient from your community is likely going to need a blood transfusion.
When we started doing Precision Blood, an interesting thing happened: essentially every donor was getting flagged as ‘rare,’ which makes sense when you think about it because now you’re talking about 300 antigens. I even discovered this about myself. I donated and my unit came up as rare, and that never happened before. I am Hispanic, and our system looks at your ethnicity and at individual antigens. It looks at the occurrence and the frequency of a given antigen—none of the antigens that I am negative or positive for are super rare. But by the combination of them, the probability falls now below 3 percent, so I got flagged as a rare donor. It really speaks to what we’re saying about Precision Blood. The best match isn’t just the ABO and Rh, it goes much deeper than that. Someone might have a rare blood type and not even be aware of it.
Through our Community Guardians Program, we’re asking for community members to help us tell the story to their community and use their trusted voice. We invite people for tours of the blood bank so that we can earn that trust, and so that you as a Community Guardian member can speak to your community and hopefully help increase the diversity of the donor base.
What is your biggest professional challenge right now?
We really need a younger donor base to step in and fill the void as our dedicated blood donors are aging out. There’s not a specific age where you can’t donate, but people often reach a point where their health means they no longer can.
Only three to four percent of people who are eligible donate. If we could move that number even slightly, it would have a huge impact. I want to emphasize how easy it is to donate: we’ll explain the situation to you if you’ve never donated before, we’ll walk you through the process. Anyone could go to our website and find a donor center (including mobile centers) near them.
We had an event last night, and one of our board members made the comment about this being an investment. I like the idea of calling it a ‘blood investment,’ because that’s what you’re doing when you’re donating blood—you’re investing in the community.
What piece of advice do you have for a young person who wants to pursue a career in life science or healthcare?
I’ve been here for 23 years, and I’ve never regretted coming to work. There’s a tremendous reward for getting into a field where you know you’re going to help people, whether it’s on the front lines or the back end. What you’re doing at work and why you’re doing it matters. I would encourage anyone to pursue that type of career.