Background: According to the revision of the Blood Management Act in 2020, medical institutions that meet certain conditions are obliged to install a transfusion management division in Korea. Therefore, this study assessed the management status of the transfusion management division at major medical institutions. Methods: From August 7th to August 18th, 2021, a survey questionnaire was given to laboratory physicians of 10 major medical institutions in Korea, and the installation and operation of the transfusion management division were surveyed. Results: The medical institutions that participated in this survey completed a transfusion management division in the first half of the year. Doctors, nurses, and medical technologists were assigned as medical personnel, and all laboratory physicians were leading the work as the head of the transfusion management division. Regarding the tasks performed at the transfusion management division, all medical institutions conducted a transfusion appropriateness assessment, education related to transfusion, and adverse transfusion reactions. Most medical institutions had difficulties because there was an insufficient basis to calculate the workforce and budget in installing and operating the transfusion management division. Conclusion There are rarely reference materials for the practice and operation of the transfusion management division, which has no precedent in Korea, so it is often difficult for medical institutions to prepare it. This study will be a reference for medical institutions that need to install a transfusion management division in the future.Efforts should be made to legislate transfusion management fees focused on the academic community.

BACKGROUND: For pretransfusion testing, ABO and D antigen tests along with unexpected antibody screening tests are performed. When unexpected antibodies are identified, selection for specific antigen-negative blood units is needed in order to ensure safety of transfusion. METHODS: A questionnaire survey was conducted from August 23 to September 10, 2012 in 36 medical institutes in order to evaluate the current status of management for specific antigen-negative blood units in Korea. The questionnaire consisted of a method for detection of unexpected antibodies, the number of antibodies identified in the last year, and the antigen tests performed for specific antigen-negative blood units. For the institutes where blood donations are obtained, we asked about the enrollment of donors for specific antigen-negative or rare blood types. RESULTS: Among the 36 institutes, antigen testing for specific antigen-negative blood units was performed in 20 institutes. Of the remaining 15 institutes, except for one institute which answered as not applicable, eight institutes requested blood units at blood centers and another seven institutes replaced antigen tests with crossmatching tests. Among the 21 institutes where blood donations are obtained, two institutes had enrolled donors for specific antigen-negative or rare blood types. CONCLUSION: For selection of specific antigen-negative blood units for recipients who have identified antibodies, standardization of antibody detection tests and antigen tests is needed. In addition, the accurate antigen frequency in the Korean population should be investigated and donors for specific antigen-negative or rare blood types should be enrolled and managed systematically. Following these efforts, practical measures for obtaining specific antigennegative blood units could be suggested for medical institutes in Korea.
Academies and Institutes ; Antibodies ; Blood Donors ; Humans ; Korea* ; Mass Screening ; Methods ; Tissue Donors ; Surveys and Questionnaires

BACKGROUND: When unexpected antibodies are identified, selection for specific antigen-negative blood units is needed in order to ensure transfusion safety. We estimated the number of blood units required for antigen testing to obtain specific antigen-negative units in Korean medical institutes. METHODS: We analyzed cases of selection for specific antigen-negative units for recipients who had antibodies identified in Seoul National University Bundang hospital from January 2008 to December 2010 and cases entered into the KRBP (Korean Rare Blood Program) online database from July 2013 to February 2014 from eight medical institutes. RESULTS: A total of 559 cases of 266 patients were analyzed. The antigen types requiring two units on average for one specific antigen-negative unit were E, P1, and Lea. Three units on average were required for one Fyb-negative blood unit, four units for one Jka-negative unit, four units for one Jkb-negative unit, 4.5 units for one Leb-negative unit, five units for one C-negative unit, six units for one M-negative unit, and seven units for one S-negative unit. In cases of obtaining specific antigen-negative units for more than one antigen type, three units on average were required for one E, c-negative unit and seven units for one C, e-negative unit. Other multiple antigen-negative units required up to 20 units. CONCLUSION: The accurate antigen-negative frequency in the Korean population should be investigated. Following this effort, the number of blood units required for selection of specific antigen-negative units could be predicted and practical measures for obtaining specific antigen-negative blood units could be suggested for Korean medical institutes.
Academies and Institutes* ; Antibodies ; Humans ; Korea ; Seoul

BACKGROUND: Alloimmunization of human platelet antigens (HPA) is associated with clinically significant disease, such as platelet refractoriness, neonatal alloimmune thrombocytopenia, or posttransfusion purpura. It is determined by single nucleotide polymorphism of genes for platelet membrane glycoprotein. To date, approximately 27 HPAs have been discovered, and their frequencies differ depending on ethnicity and country. METHODS: We conducted an investigation of prevalence of HPA in the Korean population using a multiplex single-base primer extension reaction (SNaPshot). With 84 specimens from healthy donors, HPA genotyping was performed on 11 different HPAs, including HPA-1, -2, -3, -4, -5, -6, -7, -8, -9, -13, and -15. RESULTS: A total of 90 blood samples were genotyped. The genotype frequencies of HPA were as follows: HPA-1a/1a: 100.0%, -2a/2a: 83.3%, -2a/2b: 14.3%, -2b/2b: 2.4%, -3a/3a: 39.3%, -3a/3b: 52.4%, -3b/3b: 8.3%, -4a/4a: 100.0%, -5a/5a: 95.2%, -5a/5b: 4.8%, -6a/6a: 94.0%, -6a/6b: 6.0%, -7a/7a: 100.0%, -8a/8a: 100.0%, -9a/9a: 97.6%, -9a/9b: 2.4%, -13a/13a: 100.0%, -15a/15a: 23.8%, -15a/15b: 51.2%, and -15b/15b: 25.0%. CONCLUSION: The SNaPshot assay was employed for detection of SNPs in various clinically significant HPA genes. In addition to well-known frequencies of previously reported HPA-1 to -8, this study showed frequencies of HPA-9, -13, and -15 in Koreans for the first time. The SNaPshot technique might be suitable for use in actual clinical testing in patients with platelet alloimmunization.
Antigens, Human Platelet ; Blood Platelets ; Genotype ; Humans ; Membrane Glycoproteins ; Polymorphism, Single Nucleotide ; Prevalence ; Purpura ; Purpura, Thrombocytopenic ; Thrombocytopenia, Neonatal Alloimmune ; Tissue Donors

BACKGROUND: CD36 deficiency was first identified in a patient who showed refractoriness to HLA-matched platelet transfusion. CD36 deficiency can be divided into two subgroups. The type I phenotype is characterized by platelets and monocytes exhibiting CD36 deficiency. The type II phenotype lacks surface expression of CD36 in platelets only. In this study, the frequency of type I and type II CD36 deficiency in Koreans was evaluated. METHODS: A total of 220 samples were randomly selected from subjects who requested CBC testing from August 2013 to February 2014. The expression levels of CD36 on platelets and monocytes were analyzed by flow cytometry using FITC-conjugated CD36 antibodies. Correlation between the median fluorescence intensity of CD36 and the number of platelets or monocytes was evaluated using Pearson's correlation coefficient. RESULTS: Type I phenotype, lacking CD36 on platelets and monocytes, was present in 0.9% and type II, lacking CD36 on platelets, was present in 3.2%. The median fluorescence intensity of CD36 did not show correlation with the count of platelets or monocytes. CONCLUSION: Type I subjects may produce alloantibodies against CD36 following transfusion or pregnancy, leading to refractoriness to HLA-matched platelet transfusion, post-transfusion purpura, or neonatal immune thrombocytopenia. Studies to determine exact frequency of CD36 deficiency in Koreans, including a larger population, should be conducted, and more case reports on patients immunized against CD36 are also needed in order to elucidate the clinical importance and relevance of CD36 deficiency testing and the transfusion of CD36-deficient platelets.
Antibodies ; Blood Platelets ; Flow Cytometry ; Fluorescence ; Humans ; Isoantibodies ; Monocytes* ; Phenotype ; Platelet Transfusion ; Pregnancy ; Purpura ; Thrombocytopenia

Para-Bombay phenotypes are rare blood groups that have inherent defects in producing H antigens associated with FUT1 and/or FUT2. We report the first case of para-Bombay blood type in a Southeast Asian patient admitted at a tertiary hospital in Korea. A 23-year-old Indonesian man presented to the hospital with fever and was diagnosed with a disseminated nontuberculous mycobacterium infection and anemia. During blood group typing for blood transfusion, cell typing showed no agglutination with both anti-A and anti-B reagents. Serum typing showed strong reactivity against B cells and trace agglutination pattern with A1 cells. His red blood cells failed to react with anti-H reagents. Direct sequencing of FUT1 and FUT2 revealed a missense variation, c.328G>A (p.Ala110Thr, rs56342683, FUT1*01W.02), and a synonymous variant, c.390C>T (p.Asn130=, rs281377, Se³⁵⁷), respectively. This highlights the need for both forward and reverse grouping.
ABO Blood-Group System ; Agglutination ; Anemia ; Asian Continental Ancestry Group ; B-Lymphocytes ; Blood Group Antigens ; Blood Transfusion ; Erythrocytes ; Fever ; Humans ; Indicators and Reagents ; Korea ; Mycobacterium Infections, Nontuberculous ; Phenotype ; Tertiary Care Centers ; Young Adult

Purpose: The adductor pollicis muscle is frequently targeted for botulinum neurotoxin injective treatment for spasticity. However, there are no injective guidelines for delivering injection to the muscle. Materials and Methods: A method known as the modified Sihler’s method was used to stain the adductor pollicis muscle in 16 specimens to reveal intramuscular neural distribution of the muscle. Results: The most intramuscular neural distribution was located on 1/5 to 3/5 of the muscle regarding midline of 3rd metacarpal bone (0) to the base of the 1st proximal phalanx (5/5). The nerve entry point was mostly located on 0 to 1/5 of the muscle. Conclusion The result suggests that botulinum neurotoxin should be delivered at the middle of second metacarpal bone via deep injection.