To measure iron indicators in donation failure candidates due to low hemoglobin (Hb) (DFC-LHb) and to evaluate iron deficiency from donation standard level.

After obtaining informed consent, 80 DFC-LHbs were measured for ferritin, total iron binding capacity (TIBC), serum iron and soluble transferring receptor (sTfR). We evaluated iron deficiency in 2 grades: first, AIS (absolute iron stores), defined as ferritin below 12 ng/ml, and second, IDE (iron deficient erythropoiesis), defined as Log₁₀ (sTfR/ferritin) >2.07. We also evaluated the iron deficit from donation criteria level. Furthermore, 58 candidates were measured for three indicators, except sTfR.

Among 80 who were evaluated for four indicators, 67 were classified as AIS (83.8%), 67 as IDE (83.8%) and 66/67 as AIS/IDE overlap (98.5%). Including an additional 58 subjects, 112 of the138 (81%) were classified as AIS. 38 (28%) subjects had iron deficiency exceeding 200 mg, and 25 (18%) were not iron deficient. Four of the nine who replied to our questionnaire were addicted to hard exercise.

80% of the DFC-LHb repeated with most IDE in AIS. Therefore, the significance of sTfR measurement was small. Within the DFC-LHb, 1/3 of the AIS showed more than 200 mg iron deficiency. Sports anemia was shown to be the second problem in DFC-LHb.

Adverse transfusion reactions were investigated according to clinical departments of university hospitals. Clinical signs and symptoms during and after transfusion were collected according to the methods recommended by the Hemovigilance Committee of the Japan Society of Transfusion Medicine and Cell Therapy. From 2009 to 2011, 17 universities reported 8,851 adverse transfusion reactions occurring at a rate of 0.72% per bag. Platelet concentrates (PC) induced transfusion reactions at a rate of 3.16%. The incidence of transfusion reactions with red blood cells (RBC) and fresh-frozen plasma (FPP) was 0.57% and 0.79%, respectively. In hematology and pediatric departments, PC induced transfusion reactions at relatively high rates of 3.84% and 4.79%, respectively. In nephrology departments providing dialysis, FFP induced transfusion reactions at a relatively high rate of 4.12%. The collection of all clinical signs and symptoms associated with adverse transfusion reactions among university hospitals revealed a novel risk of transfusion reactions, which had not been clear previously.

To prevent transfusion-associated HIV infection, this study sought to determine the characteristics of blood donors who were revealed to be HIV-positive after donation. From 2012 to 2014, 52 donors were revealed to be HIV-positive at Tokyo Metropolitan Blood Center. Twelve donors were detected after their first donation, while the other donors had donated at least once prior to the index donation. No significant characteristics were noted for HIV-positive subjects on the donor screening, except with respect to responses to HIV-related questions. To rule out unsuitable donors in the window period, a multi-dimensional effort including not only a questionnaire and interview but also donor education and improvement of awareness is needed.