In Japan, red blood cell (RBC) products are routinely stored at 2-6°C. However, RBC products may be temporarily exposed to temperatures outside of these storage temperatures when they are issued or tested for transfusion. In this study, we investigated the effect of exposure to temperatures outside of the storage temperatures on the quality of irradiated red blood cells-leukocytes reduced, Nisseki (Ir-RBC-LR).

When Ir-RBC-LR were exposed to 10°C for 24 hours on day 9 or 16 and returned to 4°C storage, hemolysis remained under 0.3% up to day 28. ATP levels of the test units were maintained above 3.5 μmol/gHb up to day 28.

Hemolysis of test units that were exposed to 28°C for 3 hours on day 10 or 1 hour on days 10 and 14 was lower than 0.2% up to day 28. ATP levels of both control and test units on day 28 were higher than 3.0 μmol/gHb.

These results suggest that there is no impact on the in vitro RBC quality after exposure to 10°C for 24 hours or 28°C for 3 hours.

Washed red blood cells (WRC) are effective for preventing nonhemolytic transfusion reactions. However, no report has evaluated the quality and residual plasma proteins in multiple-time washed RBC. We evaluated the quality of once, twice, or three-times washed RBC during the 72 hours after washing. Washed RBC were prepared by removing the supernatant of centrifuged RBC and adding saline. Twice or three-times washed RBC were prepared by repeatedly washing. The RBC recovery rate was more than 98% even for three-times washed RBC. Residual plasma protein, IgA, and haptoglobin (Hp) values were decreased by repeatedly washing RBC. pH was maintained at above 6.8 during the storage period. The MCV, 2.3-DPG and RBC osmotic fragility test did not significantly differ between the 3 groups. ATP was significantly decreased only in the three-times washed RBC group in the 72 hours after washing. Supernatant Hb values and hemolysis rates were higher in the multiple-times washed RBC groups than in the once-washed RBC group during the storage period, but the hemolysis rate did not increase above 0.3%. Although supernatant potassium values after washing increased in a time-dependent manner, there was no difference between the 3 groups. Residual plasma protein, IgA, and Hp levels were markedly decreased by multiple washings. The quality of RBC was well-maintained until the end of their shelf life after multiple washings.

Background: Although recombinant human soluble thrombomodulin (rhTM) is reportedly effective for treating disseminated intravascular coagulation (DIC), the prognosis for DIC patients remains still poor.

Patients and Methods: We retrospectively analyzed 136 DIC patients (infectious group: 103, hematological group: 33) treated with rhTM at a single institution between May 2012 and November 2014.

Results: The resolution rate of DIC was in 57.3% (59/103) and 54.5% (18/33) of patients in the infectious and hematological groups, respectively. The overall survival (OS) rate at 28 days was 73.8% (76/103) and 87.9% (29/33) in the infectious and hematological groups, respectively. Unexpectedly, the DIC scores were resolved in 22.2% (6/27) and 25% (1/4) and the DIC scores were reduced in 63.0% (17/27) and 50.0% (2/4) of non-surviving DIC patients, in the infectious and hematological groups, respectively. Multivariate analysis identified the Sequential Organ Failure Assessment (SOFA) score as a prognostic factor for DIC patients with infectious disease (cut-off point: 10). Moreover, high DIC and SOFA scores at diagnosis were significantly associated with poor OS of DIC patients with infectious disease.

Conclusion: Our study clearly revealed that high SOFA scores (>10) are correlated with poor outcomes for DIC patients with infectious disease. Furthermore, rhTM treatment may improve the abnormal coagulopathy in survivors and in even some populations of non-surviving DIC patients in clinical practice.

Platelet concentrate suspended in Platelet Additive Solution (PAS) is a collection in which part of the plasma is replaced with PAS, and the residual plasma concentration is approximately 20% to 35% of the total volume. Platelet concentrate suspended in PAS (PAS-PC) is reportedly useful for decreasing the incidence of allergic side effects caused by transfusion. In this study, we investigated whether it is feasible to prepare PAS-PC using the blood component collection device Trima Accel. We collected ten platelet components, targeting a 200 ml final volume, 2.5×10¹¹ total number of platelets per bag, and 35% residual plasma concentration. We obtained an average (range), volume of 197 ml (194-201 ml), a total platelet count of 2.69×10¹¹/bag (2.49-3.00×10¹¹/bag), and a residual plasma concentration of 35.0% (33.0-36.2%). Collection of PAS-PC according to the set goals was thus achievable. We examined the quality of PAS-PC collected from the same donor with the addition of either T-PAS+or Bicanate. The quality of the preparation was well maintained up until day 7 with T-PAS+. In contrast, the pH was more than 7.7 with Bicanate, which was higher than with T-PAS+, and glucose depletion was observed on day 7, and the number of platelets with spheroidal morphology was also higher.

The status of blood product use in fiscal 2016 was investigated and analyzed. The number of predictive blood transfusion patients was almost the same as that in 2015. The number of patients using red blood cell (RBC) products per treatment bed decreased, while the amount of RBC used per treatment bed increased. As a result, the usage of RBC products remained similar. The amount of each blood product used per hospital bed decreased overall, but increased in facilities with more than 500 beds. Total albumin preparation use decreased, while immunoglobulin preparation use increased.

The percentage of institutions that acquired the transfusion control fee I or II exceeded 40% for the first time in 2016. The achievement rate of appointing a transfusion physician was still less than 70%. Regarding the placement status of medical professionals authorized to perform blood transfusions, at facilities with 500 beds or more, academic society accredited-clinical blood transfusion nurses were present at 46% facilities. The nurses are required not only in hospital activities such as attending transfusion therapy committees and nurse education, but also in regional joint blood transfusion therapy committees, and therefore contribute to the promotion of safe transfusion medical treatment.