Tanaka Asashi, Fujita Hiroshi, Ohashi Kota, Tsujikawa Akihito, Uchiyama Kanami, Ito Tatsuya, Kawashima Koichiro, Kodama Reiko, Mine Takashi, Okuda Makoto, Endoh Teruo, Fukuyoshi Youko, Kitazawa Junichi, Sueoka Eisaburo, Nagai Kazuhiro, Ishida Akaru, Matsuzaki Koji, Kato Yoko, Takanashi Kazuo, Takahashi Koki
Department of Clinical Laboratory Medicine and Department of Transfusion Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
Department of Transfusion Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Vox Sang. 2023 Jan;118(1):59-67. doi: 10.1111/vox.13380. Epub 2022 Dec 1.
In Japan, there are various opinions on the pros and cons of home transfusion because of safety concerns. We hence aimed to elucidate the safety and availability of home transfusion in Japan, which has not been clarified to date.
Clinics throughout Japan that provide home care and have experience in performing blood transfusions were surveyed. The analysis period was February to December 2019. Basic information about the clinics, their collaboration system with core hospitals, storage method of red blood cells (RBCs) and the system for the management of patient information regarding transfusion reactions were investigated.
Detailed information was obtained regarding the implementation of home transfusions by 51 clinics. The proportion of home care clinics performing home transfusions was 17.6%, and they were more frequently performed in urban regions. Approximately half of the clinics collaborated with a core hospital for emergency responses to transfusion reactions. At 84% of the clinics, RBC units were stored in refrigerators that were not exclusively allocated to blood storage. Nurses and family members were involved as patient attendants in 83% and 77% of the home transfusions, respectively. No serious transfusion reactions were reported among the 150 patients in 2019, nor the 623 patients up to 2018.
From data on its availability and safety, home transfusions are considered to be in the developing phase in Japan. Increased cooperation between hospitals and clinics is crucial towards improving the home transfusion system in Japan in the future.
在日本，由于安全问题，对于家庭输血的利弊存在各种观点。因此，我们旨在阐明日本家庭输血的安全性和可行性，而这一点迄今尚未明确。
对日本各地提供家庭护理且有输血经验的诊所进行了调查。分析期为2019年2月至12月。调查了诊所的基本信息、与核心医院的协作系统、红细胞（RBC）的储存方法以及输血反应患者信息管理系统。
获得了51家诊所进行家庭输血的详细信息。进行家庭输血的家庭护理诊所比例为17.6%，在城市地区更为频繁。大约一半的诊所与核心医院合作，以应对输血反应的紧急情况。在84%的诊所中，红细胞单位储存在并非专门用于血液储存的冰箱中。护士和家庭成员分别在83%和77%的家庭输血中作为患者陪护人员参与。2019年的150名患者以及截至2018年的623名患者中均未报告严重输血反应。
从其可行性和安全性的数据来看，日本的家庭输血被认为正处于发展阶段。未来，加强医院与诊所之间的合作对于改善日本的家庭输血系统至关重要。
