Department of Blood Transfusion
Overview of the departmentBlood transfusion is supportive therapy essential for current medical practice. Blood transfusion-skilled physicians and technologists are available. They are exerting efforts to establish/maintain a hospital system for patients to undergo blood transfusion at ease, considering the key words: “safety assurance” and “optimal use of blood preparations”.
Consultation system/therapeutic strategies
Concerning safety assurance, blood-type/irregular antibody screening tests and preparation management are conducted based on a 24-hour system. This system has been facilitated by the computer-based management of all blood preparations in our hospital, making it possible to automatically check for human error on taking blood bags. There has been no report of blood transfusion-related errors.
Although it is impossible to completely prevent adverse reactions to blood transfusion, a system to evaluate all moderate or marked adverse reactions to blood transfusion has been established. Appropriate treatment and preventive measures are provided in cooperation with various departments. We have provided training on the usefulness of autologous blood transfusion as a measure to prevent adverse reactions to allogeneic blood transfusion. Last year, allogeneic blood transfusion could be avoided in approximately 130 patients.
We are also exerting efforts to promote use by departments in which autologous blood has not been sufficiently utilized. In some patients, conditions are limited. However, a system to prevent serious adverse events on blood storage and human error by centrally managing planning, blood storage, and delivery in the Department of Blood Transfusion has been established.
Concerning the appropriate use of blood preparations, we support evidence-based blood transfusion care by educating the hospital staff regarding the contents of the “Guidelines for Blood Transfusion Care” through the Blood Transfusion Therapy Committee. A target fresh frozen plasma/erythrocyte preparation ratio (FFP/RBC), published as a criterion for the appropriate use of blood preparations by the Ministry of Health, Labour and Welfare, is <0.5. In our hospital, the FFP/MAP ratio is 0.27, suggesting that blood preparations have been appropriately used in various departments. In the future, plasma derivatives, such as albumin preparations (ALB), should be appropriately used.
Advanced medical practice
Our department is equipped with a clean bench necessary for hematopoietic stem cell processing, a peripheral blood stem cell-collecting system (COBE SPECTRA), deep freezer for the storage of stem cells, and liquid nitrogen tank. In addition to hematopoietic stem cell counting with a flow cytometer, we support autologous/homologous hematopoietic stem cell transplantation, which is performed in the Department of Hematology and Oncology and Department of Pediatrics.
These are also applicable as devices for research on regenerative medicine using stem cells, which will become more advanced in the future. They may be actively utilized in various departments.
In our hospital, washed platelet concentrates are regulated for patients showing anaphylactic shock related to platelet transfusion, contributing to the prevention of recurrence.