To determine the optimal condition of blood samples applied to the stem cell monitor program of the automated hemotology analyzer, SE-9000, we examined the effects of anticoagulants, temperature and duration of storage regarding samples on immature information (IMI) and hematopoietic progenitor cell (HPC) counts, which were obtained from the IMI scatter gram of the analyzer.
IMI and HPC cell counts were stable when EDTA-2K was used as an anticoagulant for blood sampling and the samples were kept at room temperature which was approximately 37°C. However, IMI and HPC cell counts should be measured within 4 hours after blood sampling, ever in optimal conditions. Concerning those samples kept in the conditions as described above, reproducibility of IMI and HPC cell counts was good in general, although coefficients of variation were higher at low count levels of HPC cells (HPC cell<40/μl). IMI and HPC cell counts significantly correlated with CD34-positive cell count in peripheral blood (r=0.738 and 0.798, respectively). In addition, HPC cell count in the apheresis products correlated with CD34-positive cell count and CFU-GM count in the products (r=0.620 and r=0.691, respectively). These findings indicate that IMI and HPC cell counts function as a predictor useful to determine the optimal harvest time of hematopoietic progenitor cells in peripheral blood, when the samples are maintained in an appropriate condition until counting can be performed.

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血小板製剤への30Gy放射線照射と白血球除去フィルターの併用処置が血小板および血小板輸血に与える影響を検討した. 併用処置後の血小板回収率は91.8±6.5%, 白血球除去率は1.7±1.1logであった. 併用処置前後でβ-thromboglobulin や血小板第4因子の製剤内含有量, ADP, エピネフリンやコラーゲンによる血小板凝集率, また, 血小板膜上のCD62, CD42陽性率などに有意な変動を認めず, 併用処置は血小板自体に大きな影響を与えないと考えられた. 輸血1時間および24時間後の補正血小板増加数 (corrected count increment: CCI (/μL/m²)) の平均はフィルターと放射線照射の併用処置群で16,550 (n=114) および13,310 (n=93), フィルター単独群では14,970 (n=114) および10,880 (n=118) の値を示し, 両群間に有意差はなく, 併用処置に伴うCCIの低下はなかった. 輸血後の副作用発生頻度はフィルター単独群と併用処置群で発熱 (11.2vs10.1%), 蕁麻疹 (2vs0.9%), 血圧低下 (0.7vs0.7%) であった. 併用処置による副作用発生率の増加は見られなかった. これらの結果から血小板製剤への30Gy放射線照射と白血球除去フィルターの併用は, より安全な輸血のために臨床で応用できると考えられた.

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We report a case of delayed hemolytic transfusion reaction (DHTR) in which the presence of anti-Jk^b antibodies (abs) in a pretransfusion specimen was confirmed by retrospective investigation.
The patient, a 55-year-old woman, received 3, 000ml of concentrated red blood cells (CRC) during repeat mitral valve replacement surgery. Anti-Jk^b+E abs were detected by an indirect antiglobulin test using polyethylene glycol (PEG-IAT) 7 days after transfusion. The patient received two transfusions of insert 400ml of CRC with Jk^b-, E-antigen negative blood which was transfused for treatment of anemia. However, laboratory findings consistent with hemolysis were observed 17 days after the operation, and anti-Jk^b+E abs were identified from an elute of the patient's red cells with a direct antiglobulin positive test result. No special treatment was administered, however, and after 6 days, these findings disappeared entirely. The patient received compatible blood during a repeat operation, and there was no evidence of clinical hemolysis.
Anti-Jk^b abs were detected in this patient's preoperation sample by retrospective investigation using the Capture R Ready Screen (CRRS). Our case highlights the limitations of PEG-IAT. Therefore, it is considered that pretransfusion testing should be performed in combination with plural methods, especially for patients with a history of transfusion and pregnancy.

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We undertook an investigation of blood components and albumin used in sixty-eight major hospitals at Fukuoka prefecture during the first six months of 1998. An evaluation of the share of FFP and Alb in the total blood products consumption was performed. Throughout Fukuoka prefecture, 378, 502 units of blood components and Alb were used during this period. The share of FFP and Alb was 50%, FFP was 16% and Alb was 34% as respective part of the whole. The ratio of FFP and Alb usage to red blood cell products including autologous blood (P/R) was 2.53. The ratio of Alb to FFP (A/F) was 2.06. Furthermore, the comparative percentages of FFP and Alb usage of the surgical departments and the internal medicine departments of the participating hospitals were 58% and 42% respectively. The P/R and A/F of the surgical departments were 2.48 and 1.55. The share of FFP and Alb usage in digestive tract and liver surgery was 50% with P/R 3.35 and A/F 1.22 and the percentage associated with cardiovascular surgery was 25% with P/R 2.12 and A/F 1.33 in the surgical departments. The P/R and A/F of the internal medicine departments were 2.61 and 3.22. The share of FFP and Alb usage in digestive and liver diseases was 60% with P/R 4.93 and A/F 2.63 in the internal medicine departments. Accordingly, it can be said that in Fukuoka prefecture the promotion of the reasonable usage of Alb is a most important consideration, especially in digestive and liver disease and cardiovascular surgical procedures.

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In 1999, the Japan Society of Blood Transfusion organized a small committee on autologous blood transfusion. The committee was assigned to evaluate the status of predeposit autologous blood transfusion in hospitals approved by the Japan Society of Blood Transfusion and to clarify problems concerning the promotion of autologous blood transfusion. Questionnaires were sent to 86 hospitals. Information on each hospital (number of beds, number of doctors and medical technologists approved by the Society, etc), establishment of blood transfusion service, preservation methods, and management and compatibility testing of autologous blood were evaluated. In addition, number of cases and units of autologous blood transfusion from. Jan 1999 to Dec 1999 and status of homologous blood transfusion during operation were analyzed. Predeposit autologous blood transfusion was performed in all 68 hospitals which answered the questionnaire. Blood transfusion service was established in 64 hospitals. However, the place of autologous blood collection and the personnel involved in blood collection were not centralized. Percentage of autologous blood without allogeneic blood cases in cases of blood transfusion during operation was 17% in total. Percentages among hospitals ranged from 3.6% to 76.9%. Percentage of autologous blood units in units of blood used during operation was 12% in total, and ranging from 0.5% to 77.6%. Differences in the status of predeposit autologous blood transfusion were significant among hospitals. Doctors approved by the Japan Society of Blood Transfusion should assume an important role in the promotion of autologous blood transfusion in hospitals.

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The committee for autologous blood transfusion of the Japan Society of Blood Transfusion was assigned to evaluate the status of predeposit autologous blood transfusion in hospitals approved by the Japan Society of Blood Transfusion and to clarify problems concerning the promotion of autologous blood transfusion. Status of collection, management and compatibility testing of autologous blood transfusion have been analyzed and reported separately. Status of autologous blood transfusion at each surgical division was studied in this paper. Percentages of performance of predeposit autologous blood transfusion were 100% for orthopedics, 93% for cardiovascular surgery, 78% for general surgery, 91% for gynecology and obstetrics, 71% for neurological surgery and 95% for urology. Percentages of autologous blood without allogeneic blood cases and percentages of autologous blood units were higher in orthopedics, gynecology and obstetrics and urology divisions, but lower in cardiovascular surgery and general surgery. In cardiovascular surgery and general surgery, the differences in percentages of autologous blood without allogeneic blood cases and percentages of autologous blood units among hospitals were significant. Doctors approved by the Japan Society of Blood Transfusion and the blood transfusion service of the hospital should understand the status and information of blood transfusion during operation, and recognize their responsibility in promoting autologous blood transfusion in the surgical divisions where autologous blood transfusion is not performed sufficiently.

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