1.Current Status of Flow Cytometric Immunophenotyping of Hematolymphoid Neoplasms in Korea
Mikyoung PARK ; Jihyang LIM ; Ari AHN ; Eun-Jee OH ; Jaewoo SONG ; Kyeong-Hee KIM ; Jin-Yeong HAN ; Hyun-Woo CHOI ; Joo-Heon PARK ; Kyung-Hwa SHIN ; Hyerim KIM ; Miyoung KIM ; Sang-Hyun HWANG ; Hyun-Young KIM ; Duck CHO ; Eun-Suk KANG
Annals of Laboratory Medicine 2024;44(3):222-234
		                        		
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
2.Considerations for the Implementation of Automated Blood Processing System Using the Platelet-Rich Plasma Method in Korea
Dongho CHUN ; Ha Jin LIM ; Jaehyun KIM ; Duck CHO
Korean Journal of Blood Transfusion 2024;35(3):200-205
		                        		
		                        			
		                        			 Red blood cell concentrates, platelet concentrates, and fresh plasma are separated from whole blood through centrifugation. The main manufacturing methods, platelet-rich plasma (PRP) and buffy-coat (BC), are currently in use. The BC method has been increasingly adopted because of its high recovery rate of platelets and plasma, lower platelet activation, and reduced transfusion-related complications. Korea’s first Master Plan for Blood Management (2021∼2025) considered transitioning from the PRP method to the BC method and introducing automation to expand the supply of leukoreduced blood components. On the other hand, several issues have prevented this transition. In 2023, the US FDA cleared an automated system for the single centrifugation method without switching to the BC method. This paper discusses these approaches. 
		                        		
		                        		
		                        		
		                        	
3.Clinical Outcomes of Solid Organ Transplant Recipients Hospitalized with COVID-19: A Propensity Score-Matched Cohort Study
Jeong-Hoon LIM ; Eunkyung NAM ; Yu Jin SEO ; Hee-Yeon JUNG ; Ji-Young CHOI ; Jang-Hee CHO ; Sun-Hee PARK ; Chan-Duck KIM ; Yong-Lim KIM ; Sohyun BAE ; Soyoon HWANG ; Yoonjung KIM ; Hyun-Ha CHANG ; Shin-Woo KIM ; Juhwan JUNG ; Ki Tae KWON
Infection and Chemotherapy 2024;56(3):329-338
		                        		
		                        			 Background:
		                        			Solid-organ transplant recipients (SOTRs) receiving immunosuppressive therapy are expected to have worse clinical outcomes from coronavirus disease 2019 (COVID-19). However, published studies have shown mixed results, depending on adjustment for important confounders such as age, variants, and vaccination status. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively collected the data on 7,327 patients hospitalized with COVID-19 from two tertiary hospitals with government-designated COVID-19 regional centers. We compared clinical outcomes between SOTRs and non-SOTRs by a propensity score-matched analysis (1:2) based on age, gender, and the date of COVID-19 diagnosis. We also performed a multivariate logistic regression analysis to adjust other important confounders such as vaccination status and the Charlson comorbidity index. 
		                        		
		                        			Results:
		                        			After matching, SOTRs (n=83) had a significantly higher risk of high-flow nasal cannula use, mechanical ventilation, acute kidney injury, and a composite of COVID-19 severity outcomes than non-SOTRs (n=160) (all P <0.05). The National Early Warning Score was significantly higher in SOTRs than in non-SOTRs from day 1 to 7 of hospitalization ( P for interaction=0.008 by generalized estimating equation). In multivariate logistic regression analysis, SOTRs (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.12–4.11) and male gender (OR, 2.62; 95% CI, 1.26– 5.45) were associated with worse outcomes, and receiving two to three doses of COVID-19 vaccine (OR, 0.43; 95% CI, 0.24–0.79) was associated with better outcomes. 
		                        		
		                        			Conclusion
		                        			Hospitalized SOTRs with COVID-19 had a worse prognosis than non-SOTRs. COVID-19 vaccination should be implemented appropriately to prevent severe COVID-19 progression in this population. 
		                        		
		                        		
		                        		
		                        	
4.Considerations for the Implementation of Automated Blood Processing System Using the Platelet-Rich Plasma Method in Korea
Dongho CHUN ; Ha Jin LIM ; Jaehyun KIM ; Duck CHO
Korean Journal of Blood Transfusion 2024;35(3):200-205
		                        		
		                        			
		                        			 Red blood cell concentrates, platelet concentrates, and fresh plasma are separated from whole blood through centrifugation. The main manufacturing methods, platelet-rich plasma (PRP) and buffy-coat (BC), are currently in use. The BC method has been increasingly adopted because of its high recovery rate of platelets and plasma, lower platelet activation, and reduced transfusion-related complications. Korea’s first Master Plan for Blood Management (2021∼2025) considered transitioning from the PRP method to the BC method and introducing automation to expand the supply of leukoreduced blood components. On the other hand, several issues have prevented this transition. In 2023, the US FDA cleared an automated system for the single centrifugation method without switching to the BC method. This paper discusses these approaches. 
		                        		
		                        		
		                        		
		                        	
5.Clinical Outcomes of Solid Organ Transplant Recipients Hospitalized with COVID-19: A Propensity Score-Matched Cohort Study
Jeong-Hoon LIM ; Eunkyung NAM ; Yu Jin SEO ; Hee-Yeon JUNG ; Ji-Young CHOI ; Jang-Hee CHO ; Sun-Hee PARK ; Chan-Duck KIM ; Yong-Lim KIM ; Sohyun BAE ; Soyoon HWANG ; Yoonjung KIM ; Hyun-Ha CHANG ; Shin-Woo KIM ; Juhwan JUNG ; Ki Tae KWON
Infection and Chemotherapy 2024;56(3):329-338
		                        		
		                        			 Background:
		                        			Solid-organ transplant recipients (SOTRs) receiving immunosuppressive therapy are expected to have worse clinical outcomes from coronavirus disease 2019 (COVID-19). However, published studies have shown mixed results, depending on adjustment for important confounders such as age, variants, and vaccination status. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively collected the data on 7,327 patients hospitalized with COVID-19 from two tertiary hospitals with government-designated COVID-19 regional centers. We compared clinical outcomes between SOTRs and non-SOTRs by a propensity score-matched analysis (1:2) based on age, gender, and the date of COVID-19 diagnosis. We also performed a multivariate logistic regression analysis to adjust other important confounders such as vaccination status and the Charlson comorbidity index. 
		                        		
		                        			Results:
		                        			After matching, SOTRs (n=83) had a significantly higher risk of high-flow nasal cannula use, mechanical ventilation, acute kidney injury, and a composite of COVID-19 severity outcomes than non-SOTRs (n=160) (all P <0.05). The National Early Warning Score was significantly higher in SOTRs than in non-SOTRs from day 1 to 7 of hospitalization ( P for interaction=0.008 by generalized estimating equation). In multivariate logistic regression analysis, SOTRs (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.12–4.11) and male gender (OR, 2.62; 95% CI, 1.26– 5.45) were associated with worse outcomes, and receiving two to three doses of COVID-19 vaccine (OR, 0.43; 95% CI, 0.24–0.79) was associated with better outcomes. 
		                        		
		                        			Conclusion
		                        			Hospitalized SOTRs with COVID-19 had a worse prognosis than non-SOTRs. COVID-19 vaccination should be implemented appropriately to prevent severe COVID-19 progression in this population. 
		                        		
		                        		
		                        		
		                        	
6.Considerations for the Implementation of Automated Blood Processing System Using the Platelet-Rich Plasma Method in Korea
Dongho CHUN ; Ha Jin LIM ; Jaehyun KIM ; Duck CHO
Korean Journal of Blood Transfusion 2024;35(3):200-205
		                        		
		                        			
		                        			 Red blood cell concentrates, platelet concentrates, and fresh plasma are separated from whole blood through centrifugation. The main manufacturing methods, platelet-rich plasma (PRP) and buffy-coat (BC), are currently in use. The BC method has been increasingly adopted because of its high recovery rate of platelets and plasma, lower platelet activation, and reduced transfusion-related complications. Korea’s first Master Plan for Blood Management (2021∼2025) considered transitioning from the PRP method to the BC method and introducing automation to expand the supply of leukoreduced blood components. On the other hand, several issues have prevented this transition. In 2023, the US FDA cleared an automated system for the single centrifugation method without switching to the BC method. This paper discusses these approaches. 
		                        		
		                        		
		                        		
		                        	
7.Clinical Outcomes of Solid Organ Transplant Recipients Hospitalized with COVID-19: A Propensity Score-Matched Cohort Study
Jeong-Hoon LIM ; Eunkyung NAM ; Yu Jin SEO ; Hee-Yeon JUNG ; Ji-Young CHOI ; Jang-Hee CHO ; Sun-Hee PARK ; Chan-Duck KIM ; Yong-Lim KIM ; Sohyun BAE ; Soyoon HWANG ; Yoonjung KIM ; Hyun-Ha CHANG ; Shin-Woo KIM ; Juhwan JUNG ; Ki Tae KWON
Infection and Chemotherapy 2024;56(3):329-338
		                        		
		                        			 Background:
		                        			Solid-organ transplant recipients (SOTRs) receiving immunosuppressive therapy are expected to have worse clinical outcomes from coronavirus disease 2019 (COVID-19). However, published studies have shown mixed results, depending on adjustment for important confounders such as age, variants, and vaccination status. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively collected the data on 7,327 patients hospitalized with COVID-19 from two tertiary hospitals with government-designated COVID-19 regional centers. We compared clinical outcomes between SOTRs and non-SOTRs by a propensity score-matched analysis (1:2) based on age, gender, and the date of COVID-19 diagnosis. We also performed a multivariate logistic regression analysis to adjust other important confounders such as vaccination status and the Charlson comorbidity index. 
		                        		
		                        			Results:
		                        			After matching, SOTRs (n=83) had a significantly higher risk of high-flow nasal cannula use, mechanical ventilation, acute kidney injury, and a composite of COVID-19 severity outcomes than non-SOTRs (n=160) (all P <0.05). The National Early Warning Score was significantly higher in SOTRs than in non-SOTRs from day 1 to 7 of hospitalization ( P for interaction=0.008 by generalized estimating equation). In multivariate logistic regression analysis, SOTRs (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.12–4.11) and male gender (OR, 2.62; 95% CI, 1.26– 5.45) were associated with worse outcomes, and receiving two to three doses of COVID-19 vaccine (OR, 0.43; 95% CI, 0.24–0.79) was associated with better outcomes. 
		                        		
		                        			Conclusion
		                        			Hospitalized SOTRs with COVID-19 had a worse prognosis than non-SOTRs. COVID-19 vaccination should be implemented appropriately to prevent severe COVID-19 progression in this population. 
		                        		
		                        		
		                        		
		                        	
8.Considerations for the Implementation of Automated Blood Processing System Using the Platelet-Rich Plasma Method in Korea
Dongho CHUN ; Ha Jin LIM ; Jaehyun KIM ; Duck CHO
Korean Journal of Blood Transfusion 2024;35(3):200-205
		                        		
		                        			
		                        			 Red blood cell concentrates, platelet concentrates, and fresh plasma are separated from whole blood through centrifugation. The main manufacturing methods, platelet-rich plasma (PRP) and buffy-coat (BC), are currently in use. The BC method has been increasingly adopted because of its high recovery rate of platelets and plasma, lower platelet activation, and reduced transfusion-related complications. Korea’s first Master Plan for Blood Management (2021∼2025) considered transitioning from the PRP method to the BC method and introducing automation to expand the supply of leukoreduced blood components. On the other hand, several issues have prevented this transition. In 2023, the US FDA cleared an automated system for the single centrifugation method without switching to the BC method. This paper discusses these approaches. 
		                        		
		                        		
		                        		
		                        	
9.The Use of Whole Blood and Low Titer Group O Whole Blood in Managing Emergency and Trauma Patients
Ha Jin LIM ; Duck CHO ; Chan Yong PARK ; Tae-Yop KIM
Korean Journal of Blood Transfusion 2024;35(1):14-26
		                        		
		                        			
		                        			 Since the mid-2000s, massive blood transfusion protocols and damage control resuscitation have improved the prognosis of trauma patients. As a part of damage control resuscitation, whole blood transfusion, especially using low titer group O whole blood (LTOWB), has been widely accepted in both military and civilian trauma settings based on its safety and significant advantages in terms of efficiency and efficacy. To implement LTOWB effectively, each institution should establish relevant policies which should simultaneously consider safety and accessibility factors, including titer threshold, blood management, blood supply, and transfusion protocols for LTOWB. These policies will need to be revised through continuous audits and monitoring. Additionally, whole blood and LTOWB may benefit hemorrhagic patients in non-trauma contexts, or in rural and pre-hospital settings. Further supporting evidence for these applications is needed. 
		                        		
		                        		
		                        		
		                        	
10.Annual Report of the Korean External Quality Assessment Service on General Transfusion Medicine and General Transfusion Antibody Tests (2023)
Han Joo KIM ; Jin Seok KIM ; Suk-Won SEO ; Hyungsuk KIM ; Duck CHO ; Dae-Hyun KO
Journal of Laboratory Medicine and Quality Assurance 2024;46(2):73-77
		                        		
		                        			
		                        			 This report aimed to provide a summary of the 2023 survey results on the external quality assessment (EQA) scheme for the general transfusion medicine test and general transfusion antibody test programs in Korea. Proficiency testing materials were prepared at the Asan Medical Center for biannual distribution to participating laboratories. The accuracy rates and number of participating laboratories were as follows: ABO typing, 99.8%–100.0% (n=940, n=940); RhD typing, 99.8%–100.0% (n=924, n=918); crossmatching, 95.6%–99.4% (n=802, n=825); unexpected antibody screening, 99.4–100.0% (n=358, n=358); direct antiglobulin test (DAT) using a polyspecific reagent, 99.3%–100.0% (n=296, n=292); DAT using anti-immuno globulin G monospecific reagent, 100.0% (n=76, n=76); and DAT using antiC3d monospecific reagent, 97.3%–100.0% (n=73, n=73). The 2023 EQA scheme for transfusion medicine program has improved and maintained the standards of the participating laboratories. 
		                        		
		                        		
		                        		
		                        	
            
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