Abstract
The Ministry of Health, Labour and Welfare amended the guideline for blood transfusion in September, 2004. This guideline states that pre-transfusion examinations for HBsAg, HBsAb, HBcAb, HCVAb, HCV core Ag, and HIV Ab are necessary to understand a patient's infectious status, and that post-transfusion examinations of HBV (NAT), HCV core Ag, and HIV Ab are required when transfusion-associated infection is suspected. Accordingly, the Japan Society of Transfusion Medicine and Cell Therapy prepared an operation manual for the diagnosis of transfusion-associated infection. The main points are as follows: (1) Before transfusion, patient's blood sample should be kept frozen (below-20°C) in a tube for nucleic acid amplification testing in preparation for suspected transfusion-associated infection. (2) Serological markers for HBV, HCV, and HIV should be examined, as physicians need to know this information before blood transfusion. (3) Liver functions should be examined and screening tests for HBsAg, HCV Ab, and HIV Ab should be performed about three months after transfusion for early detection of post-transfusion infection. Optimal implementation of these post-transfusion diagnostic examinations requires that physicians be kept informed about this operational manual. Further, doctors should explain the possible risks of transfusion-associated infection to patients before undergoing transfusion at the time consent is provided.
