Quality control for the cryopreservation of thousands of units of placental/umbilical cord blood (PCB) is a difficult problem in cord blood banking. The Bio Archive System (BA) is a liquid nitrogen freezer tank equipped with a computer for controlled-rate freezing and a robotic arm for insertion and retrieval of the units. It is designed for the cryopreservation of up to 3, 626 units of PCB. Leukocyte concentrates prepared by the hydroxyethyl starch method were expressed into freezing bags, with large and small compartments, and then frozen and stored in the BA. The recoveries of CD34 positive cells in the large and small compartments were 95.1±9.6% and 93.5±1.6%, respectively (n=8) and the recoveries of colony-forming cell were 99.6±18.5% and 115.8±27.8%, respectively. The results indicate that the BA is useful for controlled cryopreservation of PCB in cord blood banking.
In 1999, the number of donors with HIV antibodies was 63, giving a prevalence of 1.026per 100, 000 donations collected by the Japanese Red Cross Society Blood Centers. The current frequency is higher than would be expected from the prevalence rate of HIV in Japan. We conducted a questionnaire to determine blood donor understanding of HIV. The survey looked at responses anonymously from 676 apheresis donors who donated at 8 collection offices in Aichi Prefecture in mid-January, 2000. It indicated that almost all of them were really comprehensive and 27% of respondents supported the present policy of not letting donors know the results of their HIV tests. But a tiny fraction of repeated donors did not understand why they should not donate blood as a means of checking on HIV. To reduce the risk of transfusion-transmitted infection, nucleic acid amplification test screening for HIV, HBV and HCV was introduced for all donated blood in October 1999. However, based on the rapid spread of sexually transmitted diseases and drug abuse especially among younger people, it is essential for ensuring blood safety that adequate donor education be conducted along with various approaches to reduce blood-borne infection including HIV.
We surveyed by questionnaire the management of transfusion systems and transfusion-related events during the 10-year period from 1989 to 1998 in 104 hospitals in the Tohoku district. Only thirty percent of the hospitals have their own transfusion service unit. Sixty-eight percent of hospitals which do not have transfusion service units have no plans to establish such units for several reasons: 1) lack of space and personnel 2) financial insufficiency 3) satisfaction with the existing situation 4) insufficient annual number of transfusions, and 5) reliance on other divisions or sections within the institution. More than half of the hospitals have a transfusion regulation committee; however, 45 (47%) have no committee, and 29 out of 45 have no plans to establish a committee. Laboratory controls including equipment and calibration maintenance are carried out in half of the hospitals, but few hospitals engage in error management, record and sample keeping, and staffing and personnel competency in quality audits. Fifty-three cases of transfusion-related serious events have been reported from 32 hospitals: 18 cases of ABO-incompatibile transfusion, 9 cases of transfusion associated GVHD (including suspected cases), 8 cases of hemolysis or other symptoms due to red cell antibody in recipient, 8 cases of shock or anaphylaxis of unknown cause, 6 cases of hepatitis (HB:3, HC:3), and others. Most of the major errors of ABO-incompatible transfusion occurred during nonemergency situations, in wards or on scheduled surgical operations. We conclude that retrospective information of this kind in a survey can provide the impetus to reduce transfusion-associated errors or complications. A quality control program should be established in each hospital to ensure the quality of blood procedures and the safety of transfusion practices.