S. Saito, T. Tamai, M. Ota, S. Ota, Masayoshi Komatsu, Morito Hirabayashi, K. Tamaki, Hideyuki Seshimo, Hisashi Shimizu, H. Asamura, H. Fukushima, S. Nomura
{"title":"Platelet Transfusion Refractoriness Associated With Igm-Hla-Class I Antibodies-Immunoglobulin Class Heterogeneity of Hla Class I Antibodies in Ptr Patients","authors":"S. Saito, T. Tamai, M. Ota, S. Ota, Masayoshi Komatsu, Morito Hirabayashi, K. Tamaki, Hideyuki Seshimo, Hisashi Shimizu, H. Asamura, H. Fukushima, S. Nomura","doi":"10.3925/JJTC1958.52.405","DOIUrl":"https://doi.org/10.3925/JJTC1958.52.405","url":null,"abstract":"HLAクラスI抗体が血小板輸血不応状態 (platelet transfusion refractoriness: PTR) に関与することについては数多くの報告があるが, IgM型のHLAクラスI抗体 (IgM-HLA抗体) のPTRへの関与についての報告はほとんどない. そこで, PTR患者121人の凍結保存血清のHLA抗体スクリーニングを, 磁性粒子を用いた Mixed passive hemagglutination assay (M-MPHA) 法, Flow cytometric reagents for detection of panel-reactive antibody against HLA Class I antigens (FlowPRA) 法, Anti-human immunoglobulin lymphocyte cytotoxity test (AHG-LCT) 法により行い, IgM-HLA抗体のPTRへの関与については, 輸血24時間後の補正血小板増加数 (CCI24hours) による血小板輸血効果から推測した. その結果, M-MPHA法により121症例中48症例からIgM-HLA抗体が検出された. 一方, FlowPRA法により検出できたIgM-HLA抗体は, それら48例中35例, AHG-LCT法では20例のみであった. 血小板輸血効果は, IgM-HLA抗体を保有する, 48症例中7症例74輸血において判定できた. IgM-HLA抗体の特異性に対応する抗原を持たない輸血では, CCI24hoursが19.7±4.7(×109/L) を示し輸血効果を得ることができたが, 対応する抗原を持つ輸血では, CCI24hoursが2.0±19(×109/L) を示し輸血効果を得られなかった. PTR患者に高頻度に存在するIgM-HLA抗体は, PTRの原因になると考えられ, その半数以上はAHG-LCT法により検出できなかった. M-MPHAをHLA抗体スクリーニング, 血小板輸血の際の交差試験に用いることで, PTR症例の原因解析と輸血効果の向上に貢献できる可能性がある.","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"52 1","pages":"405-413"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3925/JJTC1958.52.405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70337178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Yamamoto, T. Kamiya, H. Shibata, Y. Maeda, K. Hiruma, F. Komatsu, H. Ikeda, M. Shimizu
{"title":"FEASIBILITY AND SAFETY OF RED CELL COLLECTION BY APHERESIS TECHNOLOGY","authors":"S. Yamamoto, T. Kamiya, H. Shibata, Y. Maeda, K. Hiruma, F. Komatsu, H. Ikeda, M. Shimizu","doi":"10.3925/JJTC1958.52.44","DOIUrl":"https://doi.org/10.3925/JJTC1958.52.44","url":null,"abstract":"We evaluated the feasibility and safety of red cell collection by apheresis technology. Red cells corresponding to 600ml of whole blood were collected with two types of apheresis machine (Trima and CCS). Healthy male donors whose (circulating) blood volume was 4, 100ml or more were entered into the trial. Mean time for the entire process was 32.4min. All procedures were completed without interruption, although one case of vaso-vagal reaction was noted during collection. No sign of serious side effects was reported after collection. Red cell counts and hemoglobin values of the donors recovered to the baseline 2-3 months after collection, although serum ferritin remained at 64.4% of predonation values after 6 months.It was concluded that red cell collection by apheresis technology equivalent to 600ml of whole blood is feasible and safe. However, a large scale clinical trial will be necessary to affirm the safety of this procedure.","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"52 1","pages":"44-51"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70337377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kokichi Takahashi, S. Inaba, M. Handa, H. Sakamoto, K. Hiruma, Kazuo Kawahara, M. Matsuzaki, Yoshitsugu Kubota, K. Hodohara, Y. Imanaka, S. Otsuka, S. Kino, J. Takamatsu, K. Sagawa
{"title":"OVERALL QUESTIONNAIRE OF TRANSFUSION MEDICINE IN FISCAL 2004-STUDY OF TRANSFUSION MANAGEMENT SYSTEM AND HOSPITAL TRANSFUSION COMMITTEE-","authors":"Kokichi Takahashi, S. Inaba, M. Handa, H. Sakamoto, K. Hiruma, Kazuo Kawahara, M. Matsuzaki, Yoshitsugu Kubota, K. Hodohara, Y. Imanaka, S. Otsuka, S. Kino, J. Takamatsu, K. Sagawa","doi":"10.3925/JJTC1958.52.414","DOIUrl":"https://doi.org/10.3925/JJTC1958.52.414","url":null,"abstract":"「安全な血液製剤の安定供給の確保等に関する法律」に医療関係者の責務と明記された「安全かつ適正な輸血」の実施状況及び課題を把握するため, 輸血管理体制及び輸血療法委員会に関する調査を含む輸血関連総括的アンケート調査を2004年度に実施した.300床以上で血液製剤使用量が3,000単位以上の全医療機関777を含む1,355病院を対象とし, 829施設 (61.2%) より回答を得た. 輸血部または検査部による輸血検査・輸血用血液の一元管理体制は, 各々164施設 (19.9%), 513施設 (62.1%) において確立し, 輸血療法委員会あるいは同様の機能を持つ委員会が733施設 (88.7%) に設置されていたが, 同委員会の中心となるべき専任の輸血責任医師が任命されている施設は86施設 (10.5%) と少なかった (表2, 表4).医療機関の病床数及び輸血責任医師の専任, 兼任, 不在により分類した5群 (表1) における血液製剤の使用量, 廃棄率を比較した結果, 輸血責任医師不在の300床以上の医療機関において, 濃厚赤血球液 (RBC) 及び新鮮凍結血漿 (FFP) の廃棄率が多く, FFP使用単位数/RBC使用単位数が統計学的有意差はないものの, より多い傾向が認められた (表6).以上より, 輸血療法委員会を活用し, [安全かつ適正な輸血医療] を実践するために, 専任の輸血責任医師が重要な鍵を握るものと考えられた.","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"52 1","pages":"414-421"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70337300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Takahashi, M. Kashimura, T. Kyono, K. Matsuno, Reiko Suzuki, K. Kitsutaka, Susumu Kawahara, Koichi Kitagawa, Hiroyuki Tanaka, Tomoki Yoshioka, M. Shibuya
{"title":"ESTABLISHMENT OF URGENT TRANSFUSION ORGANIZATION IN A GENERAL HOSPITAL-EXPERIENCE WITH TYPE O BLOOD USAGE IN AN EMERGENCY ROOM-","authors":"N. Takahashi, M. Kashimura, T. Kyono, K. Matsuno, Reiko Suzuki, K. Kitsutaka, Susumu Kawahara, Koichi Kitagawa, Hiroyuki Tanaka, Tomoki Yoshioka, M. Shibuya","doi":"10.3925/JJTC1958.52.36","DOIUrl":"https://doi.org/10.3925/JJTC1958.52.36","url":null,"abstract":"To prevent delays in transfusion and the development of hemolytic transfusion reactions at the emergency room of a local hospital, we implemented a Type O blood usage program for life-threatening bleeding patients in August 2001 according to Japanese government guidelines for transfusion. To better understand actual conditions for urgent blood transfusion before and after implementation of this program, we surveyed the time between ordering to the start of transfusion, shock index at the start of transfusion, total volume of transfused blood, causes of death, irradiation of blood, side effects, and reasonable adaptation of transfusion. Results showed the time between ordering to the start of transfusion shortened to 9.3 minutes from 62.2 minutes after implementation. There was no case in which non-irradiated blood unit, was transfused, nor of incompatible blood transfusion following cross matching. Further, there was no increase in workload following implementation of the Type O blood usage program. In conclusion, Type O blood usage programs can dramatically save time between ordering to the start of transfusion. However, they carry risks such as Rh-positive blood transfusion to Rh-negative patients (about 0.5%) and antigen-positive blood transfusion to patients positive for irregular antibodies (about 1.3%). Adaptation of this transfusion must be carefully controlled. All patients receiving type O blood transfusion should be investigated for suitability after transfusion.","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"52 1","pages":"36-43"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70337354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prewarm technique はRh系抗体の検出率を低下させる","authors":"Teruo Endoh, Masateru Sasaki, Daisuke Furuya, Naoki Tsuji, Daisuke Kobayashi, Atsuhito Yagihashi, Naoki Watanabe","doi":"10.3925/JJTC1958.51.327","DOIUrl":"https://doi.org/10.3925/JJTC1958.51.327","url":null,"abstract":"Prewarm technique(PW), a method of warming reagents and samples before reaction, is used to prevent the effect of cold-reactive antibodies on the detection of warm-reactive antibodies. However, a recent report indicates the possibility that PW may attenuate the agglutination of red blood cells (RBC)induced by warm-reactive antibodies. In this study, we determined the effect of PW on detection efficiency for Rh system antibodies. We used 38 samples with Rh system antibodies(29 samples with anti-E antibody, 6 with anti-D antibody, 2 with anti-c antibody and 1 with anti-e antibody)which showed a positive reaction on 3 kinds of indirect antiglobulin tests(IAT)including 37°C saline IAT, low ionic strength saline(LISS)-IAT and the Polyethylene glycol(PEG)-IAT or bromelin method. Reduction of antibody titers induced by the prewarm technique was observed in 46.7% samples and 36.1% of samples tested by 37°C saline IAT and PEG-IAT, respectively. This reduction was observed more frequently in samples tested by LISS-IAT and the bromelin method(60.7% in LISS-IAT and 62.9% in the bromelin method). In samples with lower antibody titers(less than 2-fold), more than 30% of samples showed a negative reaction in LISS-IAT and the bromelin method. We then examined the effect a warming period on the Rh system antibodies-agglutination score. A decrease in agglutination score was observed on warming for 5 min and the extent of this decrease was enhanced at 120 min. In addition, we warmed the RBC suspension and plasma separately, and examined their effect on agglutination score. Since a decrease in agglutination score was observed only when the RBC suspension was warmed, warming of RBC may cause a decrease in warm-reactive antibodies reactivity. These results indicate that PW may attenuate not only cold-reactive antibodiesinduced RBC agglutination but also warm-reactive antibodies-induced RBC agglutination.","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"51 1","pages":"327-332"},"PeriodicalIF":0.0,"publicationDate":"2005-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70336901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"献血に関する意識調査 (第2報) -献血時のHIV感染者対策について-","authors":"道子 竹中, 勝 清水, 久實 池田, 忠宏 神谷, 井上 千加子","doi":"10.3925/JJTC1958.51.320","DOIUrl":"https://doi.org/10.3925/JJTC1958.51.320","url":null,"abstract":"The yearly increases in the rate of HIV incidence among voluntary non-remunerated blood donors (VBD) over more than 10 years is of great concern, since it threatens blood safety.A questionnaire survey on ideas about preventive measures for avoiding HIV test-seeking donors was given to members of the Japanese Society of Transfusion Medicine (JSBT; n=361) and to VBD in each donation room in 2 Japanese Red Cross Blood Centers (RCBC; n=717).Requesting self-identification cards (ID) in interviews at the time of donation was accepted by more than 80% of both groups, 85% of whom would personally continue blood donation with ID presentation. Notification of positive HIV test results was agreed to by more than 80% of each group. Regarding notification of the results to donors, interviews were mentioned by 50% of the JSBT members, and confidential letters by 71% of the VBD.The idea that donors giving false replies to HIV-related items in interviews at the time of donation should be penalized was supported by more than half of both groups, but received an undecided response from 35% of the VBD, while the idea that donors refusing to accept notification of the test results should be disqualified for donation was accepted by only 38% of the JSBT members and 20% of the VBD, and received an undecided response from 18% of the JSBT members and 43% of the VBD.These results indicate that requesting ID at interview and notification of HIV infection can be introduced into our blood program. However, treatment of donors providing untrue information at interviews and/or declining to accept test results should be resolved by providing more information on the actual attitudes of these donors.","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"51 1","pages":"320-326"},"PeriodicalIF":0.0,"publicationDate":"2005-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70336824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Ohsawa, Shio Sugita, Yuka Nakajima, Y. Furuta, Kayoko Yanagidate, K. Ichikawa, M. Kobayashi, I. Yamaguchi, K. Abe, A. Ohsaka
{"title":"IMPROVEMENT IN TRANSFUSION MANAGEMENT PRACTICES USING A NETWORK COMPUTER-ASSISTED BLOOD TRANSFUSION MANAGEMENT SYSTEM","authors":"T. Ohsawa, Shio Sugita, Yuka Nakajima, Y. Furuta, Kayoko Yanagidate, K. Ichikawa, M. Kobayashi, I. Yamaguchi, K. Abe, A. Ohsaka","doi":"10.3925/JJTC1958.51.418","DOIUrl":"https://doi.org/10.3925/JJTC1958.51.418","url":null,"abstract":"ABO-incompatible blood transfusion attributable to inadequate identification of the patient or blood unit remains the most common serious hazard of transfusion. A final bedside check to insure that the blood unit is intended for the patient is a prerequisite to the prevention of incorrect blood transfusions. We have developed a network computer-assisted blood transfusion management system, which connects with a novel barcoded patient-blood unit identification system and automated device for pretransfusion testing. This system permits a decrease in the number of manual procedures in the multiple steps of the transfusion process, and the monitoring of the bedside verification process in real-time at the transfusion laboratory. Since the initial implementation of this blood transfusion management system (July 2002), more than 17, 000 blood components (approximately 70, 000 units) have been transfused without mistransfusion. Further changes to transfusion practices, especially in the guidelines for blood component issuance for surgical operations, have resulted in a decrease in the date-expired rate and use of red cell components. This network computer-assisted blood transfusion management system may be useful for the prevention of incorrect blood transfusion attributable to human error and for the appropriate use of blood components, when used in conjunction with the patient-blood unit identification system.","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"51 1","pages":"418-423"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70336585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"LONG-TERM SURVIVAL OF TRANSFUSED PATIENTS AT A SINGLE UNIVERSITY HOSPITAL","authors":"S. Inaba, N. Kinukawa","doi":"10.3925/JJTC1958.51.507","DOIUrl":"https://doi.org/10.3925/JJTC1958.51.507","url":null,"abstract":"Long-term survival of transfused patients was studied at a single institution. This study, to our knowledge the first such report in Japan, compared long-term survival before (Group 1: 1986-1987, 1, 781 patients) and after implementation (Group 2:1992-1993 1, 326 patients) of HCV antibody screening. Unexpectedly, post-transfusion survival rate by Kaplan-Meier analysis showed no significant difference between the two groups. Female-s had a greater survival rate than male-s in both group 1 (1-year survival; male 74.1%, female 79.9%; p<0.05) and group 2 (1 year survival; male 73.7%, female 82.9%; p<0.01). There was no difference in survival between those aged 65 or more and under 65. Internal medicine patient-s had markedly lower survival than surgical patient-s (Group 2, 1-year survival; internal medicine group 58.2%, surgical patient group 84.3%; p<0.001). Transfused patients had a very high risk of death, with almost 1/4 of all patients dying within 1 year after the first transfusion.","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"51 1","pages":"507-514"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70336760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current Management of the Anemia of Prematurity","authors":"S. Finfer, R. Strauss","doi":"10.3925/JJTC1958.51.138","DOIUrl":"https://doi.org/10.3925/JJTC1958.51.138","url":null,"abstract":"","PeriodicalId":86521,"journal":{"name":"Nihon Yuketsu Gakkai zasshi = Journal of the Japan Society of Blood Transfusion","volume":"51 1","pages":"138"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70336359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}