[New guideline for transfusion medicine].
The New Guideline for Transfusion Practice (TP) and the New Criteria for Indication of Blood Products for Transfusion (BPfT) were revised in September 2005. Both are based on the New Blood Law approved in July 2003, which defines the principles of TP and determines the responsibility of the related parties. The New Blood Law and the revised guidelines require safe and appropriate TP; namely, avoid mismatched transfusion, determine indication appropriately and supply sufficiently safe blood products to cover the domestic demand. The New Guideline for TP defines the essential points of the hospital management system for appropriate TP. The establishment of a practical management system based on active hospital transfusion committee (HTC) advice is essential. The establishment of a transfusion service equipped for laboratory testing and unification of the management system of TP; a medical doctor responsible for TP with full commitment to transfusion management, a transfusion manual, specialized laboratory technicians and a 24-hour system for transfusion testing and provision are required. Autologous blood transfusion should be recommended as the safest TP, when appropriate management and operation systems are established. The New Criteria for the Indication of BPfT show the summarized criteria for the indication of each blood product at the beginning, and detailed information about each field at the end. Also described are the inappropriate use of each blood product, the trigger level and the objective level of blood components, the timing, dosage and rate of transfusion for each product, the transfusion-related record database, and the evaluation of transfusion effectiveness from the viewpoint of improvement of the clinical status as well as the laboratory data.
Takahashi
Koki
K
Transfusion Medicine & Immunohematology, the University of Tokyo Hospital, Bunkyo-ku, Tokyo.
D001803:Blood Transfusion / Q000331:legislation & jurisprudence / Q000592:standards; D006801:Humans; D007564:Japan; D017410:Practice Guidelines as Topic; D017751:Safety Management