One-on-one with Dr. George Garratty
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One-on-one with Dr. George Garratty
One-on-One with Dr. George Garratty
George Garratty, PhD, FRCPath., currently the Scientific Director of American Red Cross Blood Services, Southern California Region, is a leading Immunohematologist with over 50 years of service in the field.
Dr. Garratty has served on several national committees, including the Standards Committee of the American Association of Blood Banks and is an Associate Editor of "Transfusion".
He has also represented North America on the International Society of Blood Transfusion Council, and served as president of CBBS from 1985-1986.
He has published more than 300 scientific papers and been an author and editor of nine textbooks.
The following article is based on an interview between Dr.George Garratty and Ginny Tyler, a Southern California Regional Blood Bank Compliance Officer for Kaiser.
had already sent off his
application to the Royal Veterinary College
in London, but the rules of the era obliged students to serve two years of national service in the military first.
would have to serve two years in the Army Veterinary Corps
could go to the Royal Veterinary College
Undeterred, Dr. Garratty
recounted, "I phoned up our local hospital, knowing that hospitals kept animal houses.
Hooked, Dr. Garratty
gave up the idea of becoming a vet, and embarked upon laboratory work in the hospital's Hematology Department, which included the Transfusion
Dr. Garratty noted that Dr. Dacie was world-famous (becoming Professor Sir John Dacie), and attracted many visiting hematologists who became quite famous in their own right.
Without even realizing it, Dr. Garratty
was working alongside the world's two greatest pioneers in hematology and transfusion medicine, … and he
was brave enough (in part he
said, because he
did not realize how famous they were) to impose on them, asking questions, and discussing interesting cases with them.
50-plus years in the field so far have been anything but dull.
has seen many changes unfold since his
introduction to Immunohematology.
mentioned that he
remembers back when the UK still used glass bottles for blood collections and transfusions.
A remarkable change was the near eradication of hemolytic diseases of the fetus and newborn when Rh immune globulin came on the market in 1968, the year that Dr. Garratty
arrived in San Francisco.
Administering Rh immune globulin to Rh negative women after they delivered their babies, if they were carrying Rh positive babies, stopped the production of the antibodies that might harm the mother's subsequent babies.
also described how the discoveries of new blood groups accelerated in the 1950s and 1960s.
"When I began working, we had ABO, Rh, MNS, and P1, plus a few recently described major blood groups (K, Fya, and Jka).
In the early 1950s the Duffy blood group system was discovered, named after a hemophilia patient in our hospital who made a new antibody (they couldn't call it anti-D or Du as they had already been used, so they took the last two letters of his
name, calling it anti-Fya).
We had a very small number of blood groups to deal with, and transfusions were not frequent, so we didn't see as many antibodies as we do now," he
Soon that changed - dramatically.
"Now, thanks to the antibodies people have made, and all the problems associated with these antibodies, we know about more than 300 blood group antigens on the red cell surface.
Fast forward to the modern days, and we are analyzing and testing at the DNA
When I started, there were only three antigens we were concerned with in ABO: A, B, and H. Now there are over 200 alleles in the ABO system, and the same in the Rh system.
Blood groups have become immensely complex because of these discoveries, forcing the lab tests to keep pace," Dr. Garratty
Reflecting on some changes that have shaped transfusion medicine, Dr. Garratty
highlighted the late 1970s as a time of great changes in US immunohematology, particularly in abbreviating tests.
said, "A stunning shift in philosophy occurred, and it was a very emotionally charged time.
suggestion divided the community at first, Dr. Garratty
said that eventually the country saw the sense of it; especially with an increasing interest in applying cost/benefit/risk calculations.
In 1982, Dr. Garratty
was the opening speaker in a two-day meeting in Washington to convince the FDA
to go further by changing the existing law that required antiglobulin testing on every crossmatch.
Fortunately, the law did change.
"Then, of course, along came AIDS and with it, the increasing need for more infectious disease testing," Dr. Garratty
"During my training in England, we only conducted one test on blood donors for infections transmitted by transfusions, for syphilis.
Then along came hepatitis, followed soon by the FDA
getting involved in blood banking and deciding that we could not pay donors for red cells, and requiring us to develop tests to detect hepatitis antigens.
Perhaps most significantly, the FDA
decided to classify blood as a drug.
That tremendous change, toward classifying and inspecting blood banks like a factory producing aspirins, impacted us significantly."
Relating to his research career, Dr. Garratty said: "When I came to the Red Cross, I'd never worked in a blood center; I had always worked in university hematology/transfusion medicine.
It's a living cell assay, complicated, and expensive - costing about $1000; it takes my senior researcher, Pat Arndt
two days to complete the test; we have used it successfully for more than 25 years," explains Dr. Garratty
also provided a glimpse into potential future changes.
remarked, "I give a lecture on the past, present and future of transfusion medicine, and I like to show a slide of things you might be seeing soon.
As for "artificial blood," despite attracting media attention, Dr. Garratty
noted that the two main methods of creating so-called artificial blood have been a disaster.
"One by one the clinical trials have produced poor results.
One by one the companies have folded or withdrawn their support for this area.
I almost feel like taking artificial blood off my slide given the results in the last 30 years."
pointed to another intriguing idea, which he
worked on with a group at the University of Southern California
They found that if they bind a chemical called Polyethylene Glycol (PEG), a large molecule to a red cell - which can be done easily - it blocks all the red cell antigens, including A and B. After years of experimentation, Dr. Garratty's
team reached a point that they could block every blood group antigen, but were getting reactions with human sera that could only be explained if people had antibodies to PEG.
To test this hypothesis further, they set up a rabbit model, and the rabbits made an anti-PEG that destroyed the treated red cells.
"That's when we gave up," Dr. Garratty
"It turned out that normal, healthy people have naturally occurring antibodies to PEG because it is used pervasively in a range of everyday products, such as in cosmetics, soft drinks and food processing.
This case, Dr. Garratty
commented, exemplifies just how hard it is to predict the future.
"Although after eight years of work the project did not succeed, it was still an exciting area to work on.
I've been extremely lucky in that I get up in the morning and look forward to going to work.
Every day is exciting in research … you're always facing problems you need to try and solve.
It's a continually exciting life."
There is a new method on the horizon that Dr. Garratty
believes is most promising, but like so many things he
said, we will have to wait quite a few years to see what it amounts to.
explained, "The hot new thing is cultivating red cells in the lab.
There are a number of good groups working on it in America and Europe.
They're able to do it pretty well using an embryonic stem cell, and you can even pick your blood group you want to grow from the mother cell lacking certain blood group antigens.
Although many challenges remain, Dr. Garratty
predicts the effort will grow more popular, first for reference laboratories, and eventually, to hospitals as well.
It can be a challenge to draw people into Transfusion Medicine.
Just as his mentors, Professors Dacie and Mollison inspired his interest in the field, Dr. Garratty
urged, "Try to reach students as young as possible to get them interested and curious about the world of Hematology and Transfusion Medicine.
That used to be the sole purpose of Lab Week, Dr. Garratty
"We'd throw open the doors of the lab to the public, with demonstrations, and we went to a fair amount of trouble to present our work and e