The Japanese Ministry of Health, Labor and Welfare revised "the guidelines for the implementation of the transfusion therapy" in September, 2005. In this guideline, three requirements for computer-assisted electronic cross-matching are shown.
The first requirement is that computer systems must send a warning message in case of any discrepancy in ABO/Rh (D) typing between the donor unit and blood sample of the intended recipient. The second is that the blood type of the patient must be confirmed by two or more examinations using different specimen, and the third is that the blood type of blood products must be reconfirmed in each medical institute. The first and second requirements have already been realized by the transfusion management computer system adopted in our hospital. However, as for the third requirement, the reexamination of ABO/Rh (D) typing has been implemented, but results are not recorded in the system's blood product database.
We constructed a new transfusion management system in which ABO/Rh (D) typing of blood products can be an automated by automatic analysis machine (Auto Vue* Innova: Ortho-Clinical Diagnostics Inc.) and the result can be recorded in the blood product database. This system fulfills not only all three requirements in the guideline, but excludes human error, rationalizes the procedure, and decreases labor in operations supplying suitable blood products for the patients.
To use the computer-assisted electronic cross-matching, it is necessary that the patient's latest RBC antibody screening test is negative. At present, information on RBC antibodies of patients are not shared among medical institutions. It is desirable to share information of antibody, including the history of past antibody positivity.
The establishment of "guidelines for transfusion management systems" which include minimum functional requirements of the computer system is now expected.
*Trademark of Ortho-Clinical Diagnostics Inc.
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