A newly developed leukoreduction filter system for whole blood was evaluated. Whole blood was leukoreduced with the closed system (Sepacell Integra MAP), followed by centrifugation to obtain red cells and plasma (Leukocyte-reduced plasma: LR-FFP).
Red cells were reconstituted with MAP solution (Leukocyte-reduced RCC: LR-RCC).
Residual leukocyte counts were 1.8±1.3×10⁵/bag after filtration and 0.9±0.5×10⁵/bag in LR-RCC. These values are well below those indicated in the AABB standard and CE guideline. Erythrocyte recovery rate in Sepacell MAP was 89.1±2.3%, which was not different from that in red cell concentrate without filtration (buffy coat reduced RCC: BCR-RCC).
There was no accumulation of IL-1β, IL-8 or LDH in the supernatants of LR-RCC during storage.
Further, there was no significant difference in electrolyte levels in the supernatant and red cell fractions during storage between LR-RCC and BCR-RCC.
In LR-FFP, elevation of C3a was observed in 2 of 6 samples, while elevation of LDH was not observed.

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A genetic mutation of the ABO blood group gene in the subtype underwent analysis using polymerase chain reaction (PCR) based techniques. The present study involved fifty-seven Japanese and six non-Japanese patients with the ABO blood subtype. Three mutations were detected in Japanese A-subtypes. The ratio of A0202 (cytosine to thymine) and A0203 (to guanine) alleles with a mutation at nucleotide position 1054 in Japanese A-subtype were 36% (p<0.0001) and 11% (p<0.001), respectively, with these alleles being undetectable in the A₁-type. In one case involving the A_el-subtype, A0204 allele (with a nucleotide substitution at 703) was detected. Moreover, the ratio of A0103 allele (with four nucleotide differences at 297, 526, 657 and 703) in the A-subtype was 11% and statistically higher (p<0.05) than in the Japanese A₁-group (2%). By contrast, no polymorphism was found in either the B-subtype or the normal B-type in Japanese. Concerning non-Japanese individuals, A0201 allele (with a single base deletion at nucleotides 1059 to 1061) in 5 cases of the A₂-subtype and a nucleotide substitution at 646 (thymine versus adenine) in one case of the A_x-subtype were detected in this investigation. These findings indicate the presence of characteristic mutations in Japanese A-subtypes and differences concerning mutation of the A-subtypes among races.

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Many national university hospitals in Japan do not provide physicians with transfusion service at night and on holidays. Physicians in charge are responsible for examination of blood. In this study, we analyzed the cases of red cell transfusion after service hours in our national university hospital for six months, and evaluated what could be done by a limited number of personnel.
On average there was an episode of such transfusion every 2.1 days (85 times for 80 patients). Episodes belonged to two groups: the first was 34 operation-unrelated transfusions (8 out- and 26 inpatients), and the second was 51 episodes related to surgical operation, including three subgroups: 19 transfusions during or after scheduled operation, 21 for non-gynecologic emergency operation, and 11 for caesarian section which required actually no transfusion. Massive transfusion was necessary for surgery of aortic aneurysms (3/4), ischemic heart diseases (3/3) and tumors of vertebral column (2/3), and for patients of terminal cancer (1/4). Type and screen and an on-call system for massive transfusion of more than 5 units would have helped physicians in about 70% of cases (52/74).

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Here we report the results of the National (Fact-finding) Survey on the present state of ABO-incompatible blood transfusions in Japan performed by the Japanese Society of Blood Transfusion. The targets of the survey were 777 hospitals with more than 300 beds, which have transfused more than 3, 000 units of blood products per year. The survey was performed in the style of anonymous questionnaire-based survey.
The questionnaire focused on the presence or absence of ABO-mismatched transfusions in the 5-year period, between January 1995 and December 1999. The target blood products included whole blood, red cell concentrates and fresh-frozen plasma (FFP), the platelet concentrates being excluded. Among the 777 hospitals, answer could be obtained from 575, and 20% of them have experienced ABO-mismatched transfusion at least once in the period of the study. The frequency of ABO-mismatched transfusion increased with increasing the number of beds and the units of transfused blood. Approximately 50% of the hospitals with more than 700 beds and/or with more than 40 thousand units of transfused blood per year have experienced it. ABO-incompatible transfusion was performed in 166 cases (115 hospitals), and the blood products used were red cell concentrates in 90 cases, whole blood in 5 and FFP in 71. The main causes of transfusion error were change of blood bags in 71 cases (42.8%), incorrect blood typing in 25 (15.1%), and failure to identify patient in 19 (11.5%). The transfusion errors were caused by nurses in 78 cases (44.6%), doctors in 72 (41.1%), and laboratory technicians in 18 (10.3%). The evolution of the patients transfused ABO-incompatible blood was recorded as deceased in 6, among them 1 died of hemorrhage due to severe trauma. Additional 3 cases have deceased, but the cause could not be defined as either the ABO-incompatible transfusion or the basic disease.

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