Abstract
In order to promote appropriate procedures in blood transfusion therapy, we surveyed blood transfusions performed in 1998 at Showa University Hospital. All of the homologous blood transfusions and the use of either blood or blood components prepared by the Japan Red Cross were found to be performed adequately. However, three major problems were found to exist: 0.98% of the blood components collected were found unusable due to improper handling ; blood for transfusion was collected unnecessarily from family members ; and transfusions using blood not treated with 15 Gy γ-irradiation were performed in 2.6% of the total cases. The usage of the red cell M·A·P (mannitol, adenin, phosphate: MAP) was found to be similar between the medical department and the surgical department. However, fresh frozen plasma (FFP) was primarily used by the surgical department, while platelet concentrate (PC) was mainly used by the medical department. Overestimation by physicians in the amount of MAP needed resulted in a large quantity of unused blood which was returned to the Division of Blood Transfusion. Therefore, guidelines need to be established to eliminate the waste of unused FFP and PC. Autologous blood transfusions were performed in many departments and were found to be effective in diminishing the need for homologous blood transfusions. The rate of operations that used autologous blood transfusions alone to the total number of operations that used blood transfusions was 23%. An increase in the number of autologous blood transfusions should be promoted in that more operations and procedures can be considered suitable for autologous blood transfusions. Blood transfusion reactions were reported in 0.5% of the total cases. None of the transfusion reactions were found to be severe. The cause of transfusion reactions was not identified from the blood components or from the patient status. To survey and measure the incidence of infection by transfusion of contaminated blood, an examination for the presence of syphilis, hepatitis B, hepatitis C, HIV and HTLV-1 is recommended 2 to 6 months after the blood transfusion. Although we, the Division of Blood Transfusion, provided a written notice recommending a blood examination to both the physician and the patient, the rate of compliance was only 37%. To date, no infection has been reported after a blood transfusion. It is our hope that this summary will be helpful in the establishment of more effective blood transfusion programs.
