A 91-year-old male patient with chronic obstructive pulmonary disease in the intensive care unit was issued a red blood cell unit. Shortly after issuance, the transfusion failed because of an occlusion in the bedside leukocyte reduction filter. A small clot was observed at the spike portion of the returned filter, but the transfusion failure persisted despite replacement of the filter. On the bedside inspection, a large, irregularly shaped dark clot, approximately 2×2.5 cm in size, was observed within the blood bag, obstructing the filter spike and preventing blood flow. The unit was retrieved and classified as unsuitable for transfusion, and the supplying blood center was notified. A replacement red blood cell unit was then issued. This case highlights the importance of careful visual inspections and prompt management of abnormal blood components to ensure transfusion safety.

A 64-year-old male patient diagnosed with B-cell lymphoma required regular platelet transfusions due to persistent thrombocytopenia. Over time, he developed severe transfusion-related allergic reactions, including anaphylaxis, necessitating the use of washed apheresis platelets (W-APLT). However, as the designated blood center was unable to produce W-APLT, the issue was resolved by collaborating with a neighboring blood center to source the product.Key strategies included verifying the patient’s history of transfusion-related anaphylaxis, coordinating the production schedule of blood products, and implementing administrative procedures such as pre-scheduled ambulance transport on the day of transfusion. These measures ensured the timely supply of W-APLT while minimizing the risk of product wastage. As a result, the patient successfully received multiple W-APLT transfusions without further allergic reactions. This case serves as a model for overcoming infrastructure limitations in W-APLT supply through hospital-blood center collaboration, to provide timely and safe blood products to patients at risk of severe transfusion-related allergic reactions and anaphylaxis.

A 64-year-old male patient diagnosed with B-cell lymphoma required regular platelet transfusions due to persistent thrombocytopenia. Over time, he developed severe transfusion-related allergic reactions, including anaphylaxis, necessitating the use of washed apheresis platelets (W-APLT). However, as the designated blood center was unable to produce W-APLT, the issue was resolved by collaborating with a neighboring blood center to source the product.Key strategies included verifying the patient’s history of transfusion-related anaphylaxis, coordinating the production schedule of blood products, and implementing administrative procedures such as pre-scheduled ambulance transport on the day of transfusion. These measures ensured the timely supply of W-APLT while minimizing the risk of product wastage. As a result, the patient successfully received multiple W-APLT transfusions without further allergic reactions. This case serves as a model for overcoming infrastructure limitations in W-APLT supply through hospital-blood center collaboration, to provide timely and safe blood products to patients at risk of severe transfusion-related allergic reactions and anaphylaxis.

A 64-year-old male patient diagnosed with B-cell lymphoma required regular platelet transfusions due to persistent thrombocytopenia. Over time, he developed severe transfusion-related allergic reactions, including anaphylaxis, necessitating the use of washed apheresis platelets (W-APLT). However, as the designated blood center was unable to produce W-APLT, the issue was resolved by collaborating with a neighboring blood center to source the product.Key strategies included verifying the patient’s history of transfusion-related anaphylaxis, coordinating the production schedule of blood products, and implementing administrative procedures such as pre-scheduled ambulance transport on the day of transfusion. These measures ensured the timely supply of W-APLT while minimizing the risk of product wastage. As a result, the patient successfully received multiple W-APLT transfusions without further allergic reactions. This case serves as a model for overcoming infrastructure limitations in W-APLT supply through hospital-blood center collaboration, to provide timely and safe blood products to patients at risk of severe transfusion-related allergic reactions and anaphylaxis.

A 64-year-old male patient diagnosed with B-cell lymphoma required regular platelet transfusions due to persistent thrombocytopenia. Over time, he developed severe transfusion-related allergic reactions, including anaphylaxis, necessitating the use of washed apheresis platelets (W-APLT). However, as the designated blood center was unable to produce W-APLT, the issue was resolved by collaborating with a neighboring blood center to source the product.Key strategies included verifying the patient’s history of transfusion-related anaphylaxis, coordinating the production schedule of blood products, and implementing administrative procedures such as pre-scheduled ambulance transport on the day of transfusion. These measures ensured the timely supply of W-APLT while minimizing the risk of product wastage. As a result, the patient successfully received multiple W-APLT transfusions without further allergic reactions. This case serves as a model for overcoming infrastructure limitations in W-APLT supply through hospital-blood center collaboration, to provide timely and safe blood products to patients at risk of severe transfusion-related allergic reactions and anaphylaxis.

High-quality specimens are essential for accurate laboratory results. Preanalytical errors due to issues, such as hemolysis, microclotting, and insufficient specimen volume, account for 60%–70% of laboratory errors and frequently result from improper blood collection techniques or negligence during the collection process. Therefore, standardized blood collection guidelines and continuous education are required. In Korea, standardized venous blood collection procedures have not yet been fully established, highlighting the need for an evidence-based protocol tailored to local requirements. The venous blood collection guideline presented here was adapted from international standards to conform to globally recognized practices and address the Korean clinical context. The guideline, developed by the Korean Society for Laboratory Medicine, outlines the critical steps in venous blood collection, from patient identification and consent to post-collection handling. Practical recommendations are provided for medical students, doctors, nurses, and medical technologists. The guideline addresses specific considerations for pediatric and older patients, as well as individuals undergoing blood culture tests, with an emphasis on minimizing errors and promoting the safety of patients and medical staff. The guideline includes practical tools, such as checklists and detailed information on sampling devices, to facilitate implementation. This initiative would help standardize blood collection practices, improve specimen quality, and enhance patient care by ensuring accurate laboratory results in clinical settings.

Background: Large language models (LLMs) have the potential for clinical decision support; however, their use in specific tasks, such as determining the RhD blood type for transfusion, remains underexplored. Therefore, we evaluated the accuracy of six LLMs in addressing RhD blood type-related issues in Korean healthcare. Methods: Fifteen multiple-choice and true/false questions, based on real-world transfusion scenarios and reviewed by specialists, were developed. The questions were administered twice to six LLMs (Clova X, Gemini 1.0, Gemini 1.5, ChatGPT-3.5, GPT-4.0, and GPT-4o) in both Korean and English. Results were compared against the performance of 22 transfusion medicine experts. For particularly challenging questions, prompt engineering was applied, and the questions were reevaluated. Results: GPT-4o demonstrated the highest accuracy rate in Korean (0.6), with significant differences compared with those of Clova X and Gemini (P < 0.05). In English, the results were similar across all models. The transfusion experts achieved a higher accuracy rate (0.8). Among the five questions subjected to prompt engineering, only GPT-4o correctly responded to one, whereas the other models failed. All LLM models changed their responses or did not respond when the same question was repeated. Conclusions GPT-4o showed the best overall performance among the models tested and may be beneficial in RhD blood product transfusion decision-making. However, its performance suggests that it may serve best in a supportive role rather than as a primary decision-making tool.

Background: Hemovigilance ensures transfusion safety by monitoring adverse reactions related to the use of blood and blood components. The Korean Hemovigilance System (KOHEVIS) is a passive surveillance system based on voluntary reports from clinicians, whereas the National Health Insurance (NHI) claims database serves as an active surveillance source at a national level. This study compared the characteristics of transfusion-related adverse events (TRAEs) reported in these two national data sources. Methods: TRAEs reported to the KOHEVIS, and the NHI claims database between 2015 and 2024 were analyzed.TRAEs in the claims database were identified using the Korean Standard Classification of Diseases (KCD) codes T803∼T806, which were then mapped to the corresponding categories in KOHEVIS. Annual trends and reporting patterns were compared by type of reaction. Results: In the claims database, the annual number of cases was 24∼44 for ABO incompatibility (T803), 16∼33 for Rh incompatibility (T804), and 80∼170 for allergic reactions (T805∼T806). In the KOHEVIS, the annual number of acute hemolytic reactions was 4∼8, and that of delayed hemolytic reactions was 1∼3. The total number of reports in the KOHEVIS increased from 3,387 in 2015 to 7,818 in 2024, mainly due to an increase in febrile non-hemolytic transfusion reactions (from 1,604 to 3,852) and allergic reactions (from 773 to 2,801). Conclusion The NHI claims database is suitable for nationwide trend analysis and early detection of severe TRAEs, whereas the KOHEVIS provides higher sensitivity for mild reactions. Combining the two data sources through cross-validation and phased integration could improve the accuracy and completeness of transfusion safety surveillance in Korea.

Many medical institutions have adopted a massive transfusion protocol (MTP) for the effective management of hemorrhagic shock. However, in medical institutions where severe trauma patients are infrequently admitted, the use of MTP is rare, potentially leading to deficiencies in staff proficiency and confidence when responding to severe hemorrhage events. This study introduced simulation training to improve staff skills and confidence and assess the current state of the MTP. Healthcare professionals, including physicians, nurses, medical technologist, and support staff from emergency medical center and blood bank, participated in two simulation training sessions.The Red Blood Cell (RBC) turnaround time (TAT) failed to meet the 5-minute target in both sessions, with recorded times of 10 minutes and 9 minutes, respectively. The fresh frozen plasma (FFP) TAT exceeded the 20-minute target in the first session but achieved the goal with a time of 19 minutes in the second session. Consequently, the RBC TAT target was adjusted to a more realistic 10 minutes. Operational changes, such as installing a blood product refrigerator in the emergency department and prioritizing MTP activities, were suggested to further reduce TAT. Simulation-based training can improve compliance with MTP procedures and increase staff confidence. For institutions where MTP activation is infrequent, regular simulation training and the dissemination of educational materials are crucial to ensuring a prompt and accurate response in actual severe hemorrhage events.