Tanosaki Ryuji
Center for Transfusion Medicine and Cell Therapy, Keio University School of Medicine.
Rinsho Ketsueki. 2021;62(8):1247-1255. doi: 10.11406/rinketsu.62.1247.
Blood transfusion, which has been conducted as a basic medical procedure since 17th century, is a supportive therapy to compensate loss of each blood component. All blood materials are donated, and alive and subject to decay, type-dependent for transfusion, vary in quality, may induce severe adverse reactions, such as anaphylaxis, and may transmit infectious agents. Therefore, not only the scientific and clinical decisions but also ethical considerations should be focused on for their use. All blood products are determined as "Products Derived from Specific Organism" by the Pharmaceutical and Medical Devices Law in Japan. Of note, blood management systems are different among countries; the Japanese Red Cross Society is a unique organization that collects and manufactures blood products under supervision of the Japanese Government. It establishes a hemovigilant system by which it collects all the information concerning transfusion-related adverse events and provides them to the responsible transfusion service staff of each hospital. Physicians should check all the information from the Japanese Red Cross and refer both the "Guidelines for Blood Transfusion" and "Guidelines for the Usage of Blood Products" by the Ministry of Health, Labor and Welfare for transfusion practice.
输血作为一项基本医疗程序自17世纪就已开展，是一种用于补充各类血液成分损失的支持性治疗方法。所有血液制品均来自捐赠，具有生物活性且会变质，输血时依赖血型，质量各异，可能引发严重不良反应，如过敏反应，还可能传播病原体。因此，对于其使用，不仅要关注科学和临床决策，还应重视伦理考量。在日本，所有血液制品均依据《药品和医疗器械法》被认定为“源自特定生物体的产品”。值得注意的是，各国的血液管理系统有所不同；日本红十字会是一个在日本政府监管下收集和生产血液制品的独特组织。它建立了一个血液警戒系统，通过该系统收集所有与输血相关不良事件的信息，并将其提供给各医院负责输血服务的工作人员。医生应查阅来自日本红十字会的所有信息，并参考厚生劳动省的《输血指南》和《血液制品使用指南》来进行输血操作。
