Obituary: Ruby Nelly Irene Pietersz (1942–2018)

Abstract

Ruby Pietersz, MD, PhD, passed away on 1 March 2018 at the age of 75. Her legacy: whole-blood separation into components by the buffy coat method, applicable as a routine procedure, currently used in many blood centres around the world. Ruby was born in 1942 in Malang, Dutch East Indies (now, Indonesia). Between 1944 and 1945, she was, with her mother, interned in a camp in Malang during the Japanese occupation. Ruby and her family moved to The Netherlands in 1952. She was trained as a laboratory technician, worked in a hospital in Zwolle and subsequently moved to Amsterdam in 1966 to work at the laboratory of haematology and blood transfusion of the Free University of Amsterdam. In 1967, she started studying medicine, mainly in the evening times, and became a medical doctor in 1977. Next, she became a specialist in internal medicine in 1982 and joined the Red Cross Blood Bank in Amsterdam. In that time, Hans Loos and Peter Prins, chemical engineers of the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, had preliminary results to separate whole blood in red cells, plasma and a buffy coat, containing 90% of the platelets and 70% of the white cells. From these buffy coats, platelet concentrates could be made. As part of her thesis, Ruby developed a validated method to produce leucocyte-poor platelet concentrates from five buffy coats, which could be stored for 7 days at room temperature. This method is now used in routine all over the world in many blood transfusion centres and blood banks and has increased the provision of platelet concentrates for patients enormously. Ruby further optimized the production of red cell and platelet concentrates by integrating leucocyte-removing filters in blood bag systems. Another very important development, initiated by Ruby, was the standardized cooling of whole blood from body temperature to room temperature, and subsequent overnight storage of whole blood at ambient temperature. This facilitated the uniform separation of whole blood that was collected in the afternoon and evening, during business hours the next morning, which was an enormous logistic improvement. Overnight hold also reduced the risk of bacterial contamination. With spiking experiments, Ruby proved that a 16- to 20-h hold of whole blood at room temperature, in combination with subsequent removal of the buffy coat and the remaining white cells by filtration, could abrogate the risk of contamination with Yersinia enterocolitica. The buffy coat method in combination with overnight room temperature storage of whole blood quickly found acceptance all over the world. Ruby was particularly proud that Canadian Blood Services in Canada moved to the buffy coat method after 2006. Her research continued after Blood Bank Amsterdam became part of the national Sanquin Blood Supply organization in 1998, when she became manager of Research, Development and Education. She found great enjoyment in sharing her knowledge. She travelled to many countries to assist blood processing facilities to implement the buffy coat method. She received numerous visitors from other blood centres all over the world to learn how the buffy coat procedure worked in routine conditions. She set up national training courses for blood bank staff which still continue to this day, and trained many physicians, including haematologists and transfusion specialists. Her work was her life fulfilment. However, Dutch laws are strict and she had to retire at the age of 65 in 2007. She found new enjoyment in having more time to care for her family and friends. After her retirement, she did continue to travel abroad to help blood banks to set up their procedures. In 2014, she had an important role in the European IPA project to strengthen the Blood Transfusion Organization in the former Republic of Macedonia. Her last publication [Pietersz et al., Int J Clin Transfus Med 2016;3:55] can be regarded as her testament; Good Manufacturing Procedures, SOPs, training, validation, and traceability all were regarded extremely important by Ruby. When she retired, she was knighted as Officer in the Order of Orange-Nassau for her many achievements for society. She was an honorary member of the Dutch Transfusion Society, and of the BEST Collaborative, of which she was a founding member. Early January 2018, we were informed that she had an incurable kidney tumour. Ruby had the following motto in her PhD thesis: ‘People without friends are poor. I did not know I was so rich’. Ruby wanted this motto to be used on her mourning card, to reflect the warmth of true friendships that she had had in her life. She will be missed by her family, friends and colleagues around the world, especially for the kind person that she was.