A global effort was made to respond to COVID-19 using convalescent plasma therapy. The United States Food and Drug Administration Emergency Use Authorization facilitated rapid deployment, enabling the treatment of 94,287 patients by August 2020. The guidelines continuously evolved to emphasize the importance of a high titer plasma and specific immunocompromised patient groups. Korea has developed guidelines for treatment with convalescent plasma based on the successful treatment of two patients. By December 2023, convalescent plasma was collected from 67 donors at nine blood centers and transfused to 67 patients at 10 hospitals in Korea. The Association for the Advancement of Blood and Biotherapies recommendations, based on recent research, are believed to encompass the therapeutic effects of convalescent plasma therapy in COVID-19 patients. Korea initially considered convalescent plasma but experienced difficulties in development because of the switch to hyperimmune globulin and monoclonal antibodies. The insights gained from COVID-19 convalescent plasma treatment will be helpful in future pandemics caused by new infectious agents, underscoring the importance of domestic readiness for timely policy implementation.

Purpose: Presently, Korea is facing new challenges associated with an imbalance in blood supply and demand. The purpose ofthis study was to examine trends in blood supply and demand in Korea over the past 10 years through 2018 and to propose whatto prepare in the future. Materials and Methods: Age demographics in Korea were analyzed using data from the Statistics Korea. Blood donation andblood supply data were analyzed using Blood Services Statistics 2018 by the Korean Red Cross. Blood transfusion data from hospitalsin 2018 were obtained from the Health Insurance Review and Assessment Service. Results: In 2018, 2883270 whole blood and apheresis units were collected in Korea. The Korean Red Cross supplied 4277762 bloodcomponents to 2491 hospitals. The overall blood donation rate was 5.6%, and the most frequent donors were young male donors.Leukoreduced red blood cells (RBCs) constituted 25% of all RBCs used, and 40% of all platelets were supplied by single-donorplatelets. The self-sufficiency rate of domestic plasma with which to produce plasma-derived medicinal products was 68.7% in2018. Blood use was the most frequent among patients aged 70–79 years. Conclusion Blood management in Korea is changing rapidly due to a low birth rate, rapid aging, and an increase in severely illpatients who require most of the blood supply. Therefore, future plans to promote donation at a national level and optimal use ofblood in hospitals is necessary.

A 22-year old female patient with systemic lupus erythematosus presenting microangiopathic hemolytic anemia was treated with therapeutic plasma exchange 23 times. The patient's condition and laboratory findings (aspartate aminotransferase, alanine aminotransferase, ferritin, total bilirubin, and lactate dehydrogenase) did not improve despite the initial 18 therapeutic plasma exchange treatments. Thrombotic thrombocytopenic purpura was ruled out due to normal ADAMTS-13 activity test result; hemophagocytic lymphohistiocytosis was diagnosed based on fever, splenomegaly, pancytopenia, hypertriglyceridemia, hyperferritinemia, and hemophagocytosis in bone marrow aspiration. The patient's condition improved rapidly upon treatment with a combination of immunosuppressants and cytotoxic agents, and more therapeutic plasma exchanges were performed five consecutive times with prolonged intervals in between. We observed that therapeutic plasma exchange treatment alone was not effective enough to treat hemophagocytic lymphohistiocytosis, unlike thrombotic thrombocytopenic purpura. Therefore, it is necessary to determine and start drug administration promptly in the treatment of hemophagocytic lymphohistiocytosis with thrombotic microangiopathy.
Alanine Transaminase ; Anemia, Hemolytic ; Bilirubin ; Bone Marrow ; Cytotoxins ; Female ; Ferritins ; Fever ; Humans ; Hypertriglyceridemia ; Immunosuppressive Agents ; Lactic Acid ; Lupus Erythematosus, Systemic ; Lymphohistiocytosis, Hemophagocytic ; Pancytopenia ; Plasma Exchange ; Plasma ; Purpura, Thrombotic Thrombocytopenic ; Splenomegaly ; Thrombotic Microangiopathies

No abstract available.
Bacteremia ; Immunocompromised Host ; Korea

BACKGROUND: Next-generation sequencing is increasingly used for taxonomic identification of pathogenic bacterial isolates. We evaluated the performance of a newly introduced whole genome-based bacterial identification system, TrueBac ID (ChunLab Inc., Seoul, Korea), using clinical isolates that were not identified by three matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) systems and 16S rRNA gene sequencing. METHODS: Thirty-six bacterial isolates were selected from a university-affiliated hospital and a commercial clinical laboratory. Species was identified by three MALDI-TOF MS systems: Bruker Biotyper MS (Bruker Daltonics, Billerica, MA, USA), VITEK MS (bioMérieux, Marcy l'Étoile, France), and ASTA MicroIDSys (ASTA Inc., Suwon, Korea). Whole genome sequencing was conducted using the Illumina MiSeq system (Illumina, San Diego, CA, USA), and genome-based identification was performed using the TrueBac ID cloud system (www.truebacid.com). RESULTS: TrueBac ID assigned 94% (34/36) of the isolates to known (N=25) or novel (N=4) species, genomospecies (N=3), or species group (N=2). The remaining two were identified at the genus level. CONCLUSIONS: TrueBac ID successfully identified the majority of isolates that MALDI-TOF MS failed to identify. Genome-based identification can be a useful tool in clinical laboratories, with its superior accuracy and database-driven operations.
Genes, rRNA ; Genome ; Gyeonggi-do ; Mass Spectrometry ; Seoul

Convalescent plasma therapy has been used to achieve passive immunization against diverse infectious agents by administering pathogen-specific antibodies. Coronavirus disease 19 (COVID-19), which originated in Wuhan, China, has recently become a major concern all over the world. There are no specific treatment recommendations for COVID-19 because of the lack of knowledge and evidence about this virus. Convalescent plasma therapy can be used as an empirical and investigational treatment for COVID-19, and so we briefly describe the main issues related to convalescent plasma therapy from the perspective of transfusion medicine.

BACKGROUND: Transfusion-related acute lung injury (TRALI) is defined as acute respiratory distress syndrome with non-cardiogenic pulmonary edema caused by transfusion. It occurs only rarely but could result in patient mortality. TRALI has been declining since the successful adoption of TRALI risk mitigation strategies in several countries. The new diagnostic criteria were suggested in 2019 based on the knowledge and experience gained throughout the last decade. This article integrated a series of TRALI cases diagnosed in a tertiary hospital while reviewing each case based upon the new diagnostic criteria. METHODS: Among the reported transfusion adverse reactions that occurred from March 2013 to June 2019, seven TRALI cases were recruited for this study. Each case was retrospectively reexamined with its clinical condition and transfusion history. The diagnosed cases were classified into TRALI subtypes newly suggested in the 2019 version. RESULTS: The mean time interval to adverse reaction was 117 minutes (range: 7~370 minutes) and all satisfied the condition of hypoxemia and bilateral pulmonary infiltrations. The transfused blood components were apheresis platelets in three cases, platelet concentrates in one case, red blood cells in one case and combinations of different products in two cases. Five cases were diagnosed as possible TRALI, and all five cases were diagnosed as TRALI type 2 (2019 criteria). CONCLUSION In our center, seven patients were diagnosed TRALI during the last 6 years. Screening more TRALI patients according to the new criteria, along with investigating the patients' clinical characteristics, transfused blood components, treatments and integrated research, will facilitate Korean research on this field of medicine.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 not yet has established its treatment, but convalescent plasma has been expected to increase survival rates as in the case with other emerging viral infections. We describe two cases of COVID-19 treated with convalescent plasma infusion. Both patients presented severe pneumonia with acute respiratory distress syndrome and showed a favorable outcome after the use of convalescent plasma in addition to systemic corticosteroid. To our knowledge, this is the first report of the use of convalescent plasma therapy for COVID-19 in Korea.