Present Status of Blood Transfusion in Kansai Medical University Hospital: Problems and Measures for Improvement

Abstract

In Nov.1989, the Japanese Welfare Ministry enacted the "Guidelines for proper blood transfusion therapy" which urged us to proper use of blood components and plasma derivatives. In 1990,58,318 units in total of blood components and plasma derivatives were consumed, of which concentrated red cells (CRC) composing 15.7%, platelet concentrate (PC) 35.9%, and fresh frozen plasma (FFP) 48.4%. Compared with the number of the units used in 1987, CRC was stable, while PC rose up to 2.1 times and FFP to 1.4, respectively. The amount of FFP consumed in our hospital was much higher than that of average (33.6%) in Japan. On the other hand, although the proper ratio of C (cross matched units)/T (transfused units) should be less than 1.5, the ratio in our hospital was high; i. e.1.0-6.5, the mean 2.4. The ratio was particularly high in the surgical departments due to the excess reserve of blood components and plasma derivatives for their operations and to slow return of the unused blood products.
From Dec.,1990 to Jan.,1991, Type & Screen (T&S) and Maximum Bl ood Order Schedule (MSBOS) had been applied to 157 patients for trial; in almost all of them except for only two blood transfusions were unnecessary after all. Moreover, since July,1990,1402 units of FFP per month could be curtailed without any clinical troubles by means of cutting down the excess request for FFP. Hereafter, we have to accelate the application of T&S and MSBOS, along with the appreciation of the Guidelines and of our agreements covering blood banking services, in order to improve the efficiency of blood transfusion therapy in our hospital.