Blood utilization review has recently been used to minimize inappropriate transfusion, reduce post transfusion infections and improve the quality of transfusion practices. Ajou University Hospital is a 906 bed tertiary care teaching institution. Since March, 1995, the concurrent review of blood transfusion requests using institutional blood transfusion criteria has been initiated. To evaluate the effectiveness of the transfusion review, the units of blood components transfused per patient(total number of units of blood components transfused/total number of patients discharged) and inappropriate transfusion ratio of blood components(total number of units of blood components inappropriately transfused/total number of units of blood components transfused) were compared during the concurrent review for 9 months and pre-concurrent review for 9 months, respectively. The possible savings of blood components realized by the review were also extrapolated. The results were as follows : 1. The unit transfused per patient for pre-review and during review were 0.675 (9,080/ 13,422) and 0.654(12,123/18,546) for packed RBC(PRBC); 0.417 (5,602/ 13,422) and 0.296 (5,444/18,546) for fresh frozen plasma(FFP); 0.372(5,007/13,422) and 0.424(7,868/18,546) for platelet con-centrates(PC), respectively. 2. The inappropriate transfusion ratio of blood components for pre-review and during review were 0.039 and 0.009 for PRBC; 0.321 and 0.064 for FFP; 0.143 and 0.008 for PC, respectively. These differences were statistically significant(p=0.000). 3. The PRBC and FFP anticipated to have been saved by this review was 519 units and 2,992 units annually, respectively. 4. However, 2,621 units of PC were used additionaly during this review due to increased number of oncology patients and better hemostatic therapy practiced during the same period. In conclusion, the concurrent review of transfusion requests was very effective tool to educate residents in clinical departments the transfusion medicine and improve utilization of blood and its components.
Blood Platelets ; Blood Transfusion* ; Concurrent Review* ; Humans ; Income ; Tertiary Healthcare ; Transfusion Medicine ; Utilization Review

The results of ABO blood typing in 64-year-old patient with chronic renal and heart failure were positive with anti-B, delayed and weak positive with anti-A in the slide method for the cell typing, mixed-field agglutiniation by light microscopy in the tube method for the cell typing, and also was negative in anti-A, lectin and positive in anti-H, therefore blood typing of this patient was confirmed to A3B.
Blood Grouping and Crossmatching ; Heart Failure ; Humans ; Microscopy ; Middle Aged

BACKGROUND: There is no comprehensive report on the donor reaction rate among blood donors in South Korea. We attempted to analyze the patterns and rates of immediate blood donor reactions and the current status of the reporting system in our country. METHODS: Immediate donor reaction rate was defined as the number of donor reaction cases in 10,000 donations during or immediately after donation. We retrospectively analyzed the 4,835,499 donations collected in 2 yr (2008 and 2009) at the Korean Red Cross Blood Center. The data presented are the average data of the 2 yr. RESULTS: The overall donor reaction rate was 8.7. The rate for subcutaneous bleeding, vasovagal reaction, and nerve injury was 4.1, 4.0, and 0.1, respectively. For citrate reaction, which occurred among apheresis donations, the donor reaction rate was 0.4. The overall reaction rates among male and female donors were 6.0 and 16.2, respectively. The rates were highest in teenagers (12.0) and lowest in those in their forties (4.3). The most frequent reaction in male donors was subcutaneous bleeding (3.3); that in female donors was vasovagal reaction (8.9). CONCLUSIONS: The donor reaction rate of the study was lower than that of other countries or that of domestic prospective studies by a local blood center. These data suggested that the reporting system for blood donor reactions in Korean donors is not active, and that national standards and the continuing education of blood-collection personnel regarding donor reactions should be established to ensure reliable data collection.
Adolescent ; Blood Component Removal ; Blood Donors ; Citric Acid ; Data Collection ; Dietary Sucrose ; Education, Continuing ; Female ; Hemorrhage ; Humans ; Male ; Red Cross ; Republic of Korea ; Retrospective Studies ; Tissue Donors

No abstract available.
Classification* ; Dermatoglyphics* ; Yersinia*

BACKGROUND: Transfusion is a choice of treatment and should be used in order to maintain patients' lives and health. In order to supply safe blood, the quality improvements of hospital blood collection centers should be periodically monitored. To establish systematic surveillance of blood management system, we would like to suggest proper program. METHODS: Twenty-nine hospital small scale blood centers, collects less than 100 units of blood collection per year, were evaluated. Qualified were selected among blood bank specialists who were eligible to simultaneously perform inspections and consultations, and who had attended inspectors' workshop. RESULTS: Among twenty-five blood collection centers, four blood collection centers were closed prior to inspections. Among them, two blood collection centers were evaluated as inadequate. Among adequate centers, some questionnaires were evaluated as "not applicable" mainly for reasons pertaining to personnel and facilities, such as blood component preparation rooms and/or center administrators. CONCLUSION: A checklist for an inspection program should be reviewed continuously. Additionally, detailed guidelines for inspection should be standardized prior to commencing of subsequent year's inspection program. Finally, guidelines for inspection should be established for every questionnaire.
Blood Banks ; Checklist ; Quality Improvement ; Referral and Consultation ; Specialization ; Surveys and Questionnaires

Backgroud: To evaluate the appropriateness of the requests of the emergency transfusions, 3 year experiences in the use of the immediate-spin crossmatched blood(ISMB) for emergency transfusions in tertiary hospital were reviewed. METHODS: Low-isotonic salt solution was used as a cell suspension and crossmatchings were continued including antiglobulin phase after issuing of the ISMB. The number of cases, the issuing time, sex, age, reasons for emergency transfusions and vital signs of the patients were retrospectively reviewed. Only cases of massive transfusions and classes III and IV according to the Advanced Trauma Life Support(ATLS) classification were considered appropriate. RESULTS: 1. The total number of emergency transfusions were 614 and 0.53 cases per day. The average age of the patients was 44.7+/-17.8 and male to female ratio was 2:1. And 357 cases(58.2%) were performed during off hours when the hospital was not fully staffed. 2. Six hundred thirteen cases(99.8%) were transfused with compatible blood. However, one case(0.2%) was found to have anti-E antibody during the emergency transfusion. 3. Massive transfusion was performed only in 32% of the total cases and the reasons of emergency transfusions in remaining cases were upper gastrointestinal bleeding(53%), trauma(19.2%) and obstetrical problems(16.8%). 4. Of the total 519 cases reviewed, 392 cases(75.5%) were considered appropriately, and 127 cases(24.5%) were considered inappropriately selected for emergency transfusions. CONCLUSIONS: One fourth of emergency transfusions was found to be inappropriate. We believe that the use of ISMB for emergency transfusions should be carefully requested by physicians and educational programs for the use of ISMB is clearly indicated for emergency transfusion management.
Classification ; Emergencies* ; Female ; Humans ; Male ; Retrospective Studies ; Tertiary Care Centers ; Vital Signs

Authors found a case of anti-Yka antibody in a 66-year-old female patient with acute peritonitis due to colon cancer perforation. Although anti-Yka antibody has no clinical significance, its high-titer, low-avidity (HTLA) characteristics with weak and variable reactivity to Yk(a+) RBC in the indirect antiglobulin test can cause confusion and difficulties in identifying coexisting clinically significant antibodies. Titration studies could be used to determine such reactions due to HTLA antibodies. Since anti-Yka antibody has not been shown to cause significant destruction of transfused Yk(a+) RBC, Yk(a+) units can be safely transfused to patients with anti-Yka antibody unless clinically significant antibodies coexist in their sera. This is the first case report of anti-Yka antibody as an high-titer, low-avidity antibody in Korea.
Aged ; Antibodies ; Blood Transfusion ; Colonic Neoplasms ; Coombs Test ; Female ; Humans ; Korea ; Peritonitis

BACKGROUND: The results of a particular test can be affected by the techniques used for testing. However, limited data is available on the testing techniques used in blood bank laboratories in Korea. The aim of this study was to evaluate the various testing techniques used in blood bank laboratories using the data obtained during the past six years from the Korean external quality assessment (KEQA) of blood bank laboratories. METHODS: Data was collected from all KEQA respondents via the KEQA website on the testing techniques used in blood bank laboratories from 2008 to 2013. The survey included questions on ABO grouping, D typing, crossmatching tests, direct antiglobulin tests (DAT), antibody (Ab) screening, and Ab identification (ID) tests. RESULTS: Based on the data obtained from 2008 to 2013 (ABO grouping data obtained from 2011 to 2013), the most frequently used techniques are as follows: slide agglutination (60.7% and 60.8%) for ABO cell typing; tube agglutination (78.2% and 81.2%) for ABO serum typing; slide agglutination (50% and 54.6%) for D typing; tube agglutination (91.9% and 83.8%) for crossmatching tests; tube agglutination (63.6% and 52.8%) for DAT; column agglutination technique (CAT; 74.5% and 89.4%) for Ab screen; and CAT (83.9% and 94.2%) for Ab ID. CONCLUSIONS: The findings reveal a steady increase in the use of CAT from 2008 to 2013 for crossmatching tests, DAT, Ab screen, and Ab ID and a decreasing use of the tube agglutination technique for the past six years. Since the slide agglutination technique accounted for a significant percentage of the tests conducted, further education is warranted on the improvement in the techniques used for ABO and D typing.
Agglutination ; Agglutination Tests ; Animals ; Blood Banks* ; Cats ; Clinical Laboratory Techniques ; Coombs Test ; Surveys and Questionnaires ; Education ; Korea ; Mass Screening

BACKGROUND: The blood component wastage leads to an unnecessary expensive cost of operation, and thus we have monitored the reasons for such wastage and have taken corrective actions to reduce the amount of discarded blood. METHODS: To evaluate the effectiveness of the corrective actions for blood wastage, rates and reasons for blood wastage were compared during the monitoring period of 78 months and the pre-monitoring period of 6 months. RESULTS: The wastage rates of total blood components, red blood cells (RBC), platelet concentrates (PC) and fresh frozen plasmas (FFP) for the pre-monitoring were 1.23%, 1.31%, 0.59% and 2.19%, and for the monitoring period 0.4%, 0.15%, 0.19% and 1.4%, respectively. These differences were statistically significant (P<0.001). The reasons for RBC wastage were inattention of the hospital staff 26.9%, moving of blood along with the patients 20.2%, death or discharge because of hopelessness 17.8%, refusal of the patients 13.9%, mishandling of blood by hospital staff 8.7%, the change in the patient's condition 7.7% and other 4.0%. The reasons for PC wastage were death or discharge because of hopelessness 56.0%, inattention of the hospital staff 19.4%, the change in the patient's condition 16.0%, mishandling of blood by hospital staff 4.9% and refusal of the patient 3.7%. CONCLUSION: Continuous corrective actions and monitoring of the blood wastage were effective in reducing the rates of wastage, particularly the RBC.
Blood Platelets ; Disulfiram ; Erythrocytes ; Humans ; Plasma

BACKGROUND: The aim of this study was to report the first experience of using tests of antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B surface antigen (anti-HBs) for the selection of blood donors in a tertiary hospital blood center in Korea. METHODS: From January 2005 to December 2007, the data of all eligible donors according to the Korean Blood Regulation Law were analyzed. Anti-HBc testing was performed in all donors, but anti-HBs was tested only in anti-HBc seropositive donors. Anti-HBs negative but anti-HBc positive donors were regarded as ineligible for blood donation. Cost for donor testing was calculated based on Korean health insurance payment schedule from 2005 to 2007. RESULTS: The seroprevalence of anti-HBc in blood donors was 23.2% (162/699) and increased with increasing age. The proportion of ineligible donors for blood collection was 2.7% (19/699) of total donors and 11.6% (19/162) of anti-HBc seropositive donors. The cost of testing for anti-HBc and anti-HBs was estimated to be about 40% of the total screening cost. CONCLUSIONS: Although additional donor screening tests for anti-HBc and anti-HBs requires increased cost and relatively small number of donors are additionally excluded by these tests, they are considered to be helpful for the safety of blood products, because our blood center has characteristics with small number of donors and relatively high percentage of donors in the age group of thirties and older.
Adolescent ; Adult ; Age Factors ; Blood Banks ; *Blood Donors ; Hepatitis B/diagnosis/economics ; Hepatitis B Antibodies/*blood ; Hepatitis B Core Antigens/*immunology ; Hepatitis B Surface Antigens/*immunology ; Humans ; Korea ; Laboratories, Hospital ; Middle Aged ; Seroepidemiologic Studies ; Serologic Tests/economics