[in Japanese]

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Allogeneic hematopoietic stem cell transplantation is the only curative treatment for severe combined immunodeficiency (SCID). Recently, we treated two children with SCID (X-linked SCID and adenosine deaminase (ADA) deficiency) who underwent bone marrow transplantations (BMT) from HLA-identical minor mismatch donors. Conditioning was not performed in the patient with X-linked SCID, whereas reduced-intensity conditioning was done in the patient with ADA deficiency. In this study, antigens on red blood cells (RBC) and chimerism of subpopulations of white blood cells (WBC) were sequentially examined. Immunological status of both patients was completely improved. The patient with X-linked SCID showed that RBCs were derived from the donor, and subpopulations of WBCs except for T cells had mixed chimerism at 2.5 years after BMT. The patient with ADA deficiency showed that all cells were derived from the donor at one year after BMT. The patient with X-linked SCID requires follow-up for a long period.

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In 2009, the Society of Medical Technologists Belonging to the Council of Blood Centers at University-Hospitals in Japan (below Society of M.T.) investigated promotion of the carrying of cards published for individuals who have clinically significant-antibodies against red blood cell antigens (below antibody card).
First, we sent a questionnaire to 80 hospitals belonging to the Society of M.T.. The questionnaire enquired about whether the hospital published antibody cards, the contents of antibody cards and issues in publishing them. Responses were obtained from 57 hospitals (response rate 71.3%). Antibody cards were published by 19 hospitals (33.3%). Antibody cards consisted of full name (kanji only 42%, both kanji and kana 32%, kana only 26%), ID number 58%, birth date 74%, blood type ABO/D 79%. Seventeen hospitals (89%) published antibody cards only to individuals who have clinically significant-antibodies against red blood cells. Second, according to the results of the questionnaire, we then proposed the format of antibody cards, namely that the contents should include the patient's basic information (name, ID number, birth date, blood type), name of antibodies, examination date and/or date of publication, and reference. Precautions in publishing antibody cards were the prevention of entry mistakes and rewriting of the contents. Finally, the purpose of publishing antibody cards is the prevention of delayed hemolytic transfusion reactions due to secondary immune reaction during the antibodies' disappearance time, and we confirmed not to omit the detailed examinations for blood transfusion.

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The "Guideline concerning the execution of the transfusion therapy" published by the Ministry of Health, Labour and Welfare requires that the activities of the transfusion committee in each hospital be documented.At the Akita Red Cross Blood Center, committee participation begun in May 2009.
The requested document was first mailed to the director of the hospital and the chairman of the transfusion committee, after which the participation of the Medical Representative or other members of the Akita Red Cross Blood Center in the transfusion committee was proposed to the chairman of each medical institution described in the document.
Members of the Akita Red Cross Blood Center joined 18 transfusion committees in Akita Prefecture between June 2009 and March 2011.
We had 23 opportunities to informed in the Hospital Transfusion Committee about consolidating of blood centers, 14 chances to discuss the bacterial contamination of blood products, and 10 chances to discuss the revision of the guideline in 2009.
We were allowed the opportunity to present training courses for blood collection, for purposes such as auto transfusion.
Positive participation in the hospital transfusion committees involving exchange of the updated information regarding transfusions and opinion seems to be important in facilitating cooperation with the blood center and medical institution.

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With the aim of standardizing the undergraduate educational program for transfusion medicine in medical schools in Japan, a standard educational curriculum was proposed by the Japan Society of Transfusion Medicine and Cell Therapy's Subcommittee for Transfusion Medicine Education. This standard curriculum was based on the actual curricula in use at the seven medical schools where the members of the subcommittee work.
The proposed curriculum calls for 5 lecture units and 3 units of clinically oriented practicum. Lecture contents were classified according to educational priority as 'required', 'strongly recommended', or 'recommended'. A minimum essential curriculum of 3 lecture units was also proposed for medical schools unable to provide the full set of 5 lectures. In addition to systematic lectures, it was suggested that each medical school also consider adopting other educational methods, such as tutorial learning, problem-based learning, role plays, and observations at the blood center. Finally, to ensure that students gain the proper skills and knowledge required to perform transfusion medicine, it was recommended that each medical school develop its own transfusion medicine curriculum based on the standard curriculum proposed by the subcommittee.

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