This report provides a summary of the 2024 survey results on the external quality assessment (EQA) scheme for the general transfusion medicine test and the general transfusion antibody test programs in Korea. Proficiency testing materials were prepared at the Asan Medical Center for bi-annual distribution to participating laboratories. The accuracy rates and number of participating laboratories for the bi-annual EQAs were: ABO typing, 99.6%–99.9% (n=944, n=945); RhD typing, 99.9%–100.0% (n=929, n=930);crossmatching, 95.0%–99.2% (n=825, n=825); unexpected antibody scre ening, 99.5%–100.0% (n=363, n=367); direct antiglobulin test (DAT) using a polyspecific reagent, 99.3%–100.0% (n=296, n=299); DAT using an antiimmunoglobulin G monospecific reagent, 100.0% (n=74, n=72); and DAT using an anti-C3d monospecific reagent, 98.6%–100.0% (n=72, n=71). The 2024 EQA scheme for the transfusion medicine program has improved and maintained the standards of the participating laboratories.

This report provides a summary of the 2024 survey results on the external quality assessment (EQA) scheme for the general transfusion medicine test and the general transfusion antibody test programs in Korea. Proficiency testing materials were prepared at the Asan Medical Center for bi-annual distribution to participating laboratories. The accuracy rates and number of participating laboratories for the bi-annual EQAs were: ABO typing, 99.6%–99.9% (n=944, n=945); RhD typing, 99.9%–100.0% (n=929, n=930);crossmatching, 95.0%–99.2% (n=825, n=825); unexpected antibody scre ening, 99.5%–100.0% (n=363, n=367); direct antiglobulin test (DAT) using a polyspecific reagent, 99.3%–100.0% (n=296, n=299); DAT using an antiimmunoglobulin G monospecific reagent, 100.0% (n=74, n=72); and DAT using an anti-C3d monospecific reagent, 98.6%–100.0% (n=72, n=71). The 2024 EQA scheme for the transfusion medicine program has improved and maintained the standards of the participating laboratories.

This report provides a summary of the 2024 survey results on the external quality assessment (EQA) scheme for the general transfusion medicine test and the general transfusion antibody test programs in Korea. Proficiency testing materials were prepared at the Asan Medical Center for bi-annual distribution to participating laboratories. The accuracy rates and number of participating laboratories for the bi-annual EQAs were: ABO typing, 99.6%–99.9% (n=944, n=945); RhD typing, 99.9%–100.0% (n=929, n=930);crossmatching, 95.0%–99.2% (n=825, n=825); unexpected antibody scre ening, 99.5%–100.0% (n=363, n=367); direct antiglobulin test (DAT) using a polyspecific reagent, 99.3%–100.0% (n=296, n=299); DAT using an antiimmunoglobulin G monospecific reagent, 100.0% (n=74, n=72); and DAT using an anti-C3d monospecific reagent, 98.6%–100.0% (n=72, n=71). The 2024 EQA scheme for the transfusion medicine program has improved and maintained the standards of the participating laboratories.

This report provides a summary of the 2024 survey results on the external quality assessment (EQA) scheme for the general transfusion medicine test and the general transfusion antibody test programs in Korea. Proficiency testing materials were prepared at the Asan Medical Center for bi-annual distribution to participating laboratories. The accuracy rates and number of participating laboratories for the bi-annual EQAs were: ABO typing, 99.6%–99.9% (n=944, n=945); RhD typing, 99.9%–100.0% (n=929, n=930);crossmatching, 95.0%–99.2% (n=825, n=825); unexpected antibody scre ening, 99.5%–100.0% (n=363, n=367); direct antiglobulin test (DAT) using a polyspecific reagent, 99.3%–100.0% (n=296, n=299); DAT using an antiimmunoglobulin G monospecific reagent, 100.0% (n=74, n=72); and DAT using an anti-C3d monospecific reagent, 98.6%–100.0% (n=72, n=71). The 2024 EQA scheme for the transfusion medicine program has improved and maintained the standards of the participating laboratories.

This report provides a summary of the 2024 survey results on the external quality assessment (EQA) scheme for the general transfusion medicine test and the general transfusion antibody test programs in Korea. Proficiency testing materials were prepared at the Asan Medical Center for bi-annual distribution to participating laboratories. The accuracy rates and number of participating laboratories for the bi-annual EQAs were: ABO typing, 99.6%–99.9% (n=944, n=945); RhD typing, 99.9%–100.0% (n=929, n=930);crossmatching, 95.0%–99.2% (n=825, n=825); unexpected antibody scre ening, 99.5%–100.0% (n=363, n=367); direct antiglobulin test (DAT) using a polyspecific reagent, 99.3%–100.0% (n=296, n=299); DAT using an antiimmunoglobulin G monospecific reagent, 100.0% (n=74, n=72); and DAT using an anti-C3d monospecific reagent, 98.6%–100.0% (n=72, n=71). The 2024 EQA scheme for the transfusion medicine program has improved and maintained the standards of the participating laboratories.

Rh hemolytic disease of the fetus and newborn is a potential risk for D-negative mothers who produce anti-D during pregnancy, which can lead to morbidity and mortality in subsequent pregnancies. To prevent this hemolytic disease, Rho(D) immune globulin (RhIG) is generally administered to D-negative mothers without anti-D at 28 weeks of gestation and shortly after delivery. However, current guidelines suggest that pregnant mothers with molecularly defined weak D types 1, 2, 3, 4.0, and 4.1 do not need RhIG as they are unlikely to produce alloanti-D when exposed to fetuses with D-positive red cells. This issue and the necessity of RHD genotyping have been extensively discussed in Western countries, where these variants are relatively common. Recent evidence indicates that women with Asiantype DEL (c.1227G > A) also do not form alloanti-D when exposed to D-positive red cells.We report that mothers with molecularly defined Asian-type DEL, similar to those with weak D types 1, 2, 3, 4.0, and 4.1, do not require RhIG before and after delivery. Collectively, this review could pave the way for the revision of international guidelines to include the selective use of RhIG based on specific genotypes, particularly in women with the Asian-type DEL.

Background: Flow cytometric immunophenotyping of hematolymphoid neoplasms (FCIHLN) is essential for diagnosis, classification, and minimal residual disease (MRD) monitoring. FCI-HLN is typically performed using in-house protocols, raising the need for standardization. Therefore, we surveyed the current status of FCI-HLN in Korea to obtain fundamental data for quality improvement and standardization. Methods: Eight university hospitals actively conducting FCI-HLN participated in our survey.We analyzed responses to a questionnaire that included inquiries regarding test items, reagent antibodies (RAs), fluorophores, sample amounts (SAs), reagent antibody amounts (RAAs), acquisition cell number (ACN), isotype control (IC) usage, positiveegative criteria, and reporting. Results: Most hospitals used acute HLN, chronic HLN, plasma cell neoplasm (PCN), and MRD panels. The numbers of RAs were heterogeneous, with a maximum of 32, 26, 12, 14, and 10 antibodies used for acute HLN, chronic HLN, PCN, ALL-MRD, and multiple myeloma-MRD, respectively. The number of fluorophores ranged from 4 to 10. RAs, SAs, RAAs, and ACN were diverse. Most hospitals used a positive criterion of 20%, whereas one used 10% for acute and chronic HLN panels. Five hospitals used ICs for the negative criterion. Positiveegative assignments, percentages, and general opinions were commonly reported. In MRD reporting, the limit of detection and lower limit of quantification were included. Conclusions This is the first comprehensive study on the current status of FCI-HLN in Korea, confirming the high heterogeneity and complexity of FCI-HLN practices. Standardization of FCI-HLN is urgently needed. The findings provide a reference for establishing standard FCI-HLN guidelines.

Background: Diabetic nephropathy (DN) is a progressive complication among patients with diabetes and the most common cause of end-stage kidney disease. Neutrophil extracellular traps (NETs) are known to play a role in kidney disease, thus this study aimed to determine their role in the development of diabetic kidney disease using diabetic murine models. Results: Protein and histological analyses revealed that db/db mice and streptozotocin DN models expressed no significant NET-related proteins, myeloperoxidase, citrullinated histone H3 (citH3), neutrophil elastase, and lymphocyte antigen 6 complex locus G6D (Ly6G). However, the inflamed individuals in the DN model showed that citH3 and Ly6G were highly deposited in the renal system based on immunohistochemistry images. In vitro, NET treatment did not induce apoptosis in glomerular endothelial and renal tubular epithelial cells. NET inhibition by DNase administration demonstrated no significant changes in cell apoptosis. Conclusions NET-related proteins were only expressed in the DN model with tubulointerstitial inflammation. Our study revealed that NETs are only induced in mice with hyperglycemia-induced inflammation.

Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.

Few comparative studies on the effects of immunosuppressants in patients with idiopathic membranous nephropathy have been conducted. Methods: Data from 489 patients who received conservative treatment or immunosuppressants were retrospectively analyzed by propensity score matching. Primary outcomes were complete or partial remission (CR or PR) of proteinuria, and secondary outcomes were renal survival and infection. Results: Of the 489 patients, 357 (73.0%) received immunosuppressants. Propensity score matching identified 82 patients from the conservative group and 82 patients in the immunosuppressant group. CR or PR at 12 months was significantly higher in the immunosuppressant group compared with the conservative group for the total population (p = 0.002) and the propensity score-matched population (p = 0.02). The use of immunosuppressants was significantly more effective with respect to achieving a CR or PR at 12 months in patients who were aged <65 years or female, or who had a proteinuria level of ≥4.0 g/g or an estimated glomerular filtration rate of ≥60 mL/min/1.73 m2 (p < 0.05). Renal survival was similar between patients receiving immunosuppressants and conservative treatment in both the total and matched populations. The immunosuppressant group (21.8%) had a significantly higher incidence of infections compared with the conservative group (13.6%) for the total population (p = 0.03), but statistical significance disappeared in the matched population (p > 0.99). Conclusion: The remission rate was significantly higher in the immunosuppressant group than in the conservative group, particularly in the subgroup of patients who were young or female, or those with heavy proteinuria loads or good renal function.