title: The current status of autologous blood transfusion in Japan--the importance of pre-deposit autologous blood donation program and the needs to achieve patient blood management.
abstract: BACKGROUND
  Autologous blood transfusion (ABT) is currently considered the safest transfusion, since the risks of allogeneic immunological reaction and viral transmission are theoretically null. Although its use has declined in Western countries in the recent decade, it has been progressively expanded in Japan. With the widening of the concept of patient blood management (PBM), which aims to prevent the harmful adverse effects of the exposure to allogeneic blood, the importance of the ABT has once again gained interest.
  
  
  METHODS
  Here, we retrospectively analyzed the cases pre-depositing autologous blood for an elective surgery in the period of January 2000 to December 2010 in our hospital, where a pre-deposit autologous blood donation (PAD) program has been established in 2006, in an attempt to analyze the improvements achieved, and the problems remaining to achieve patient blood management.
  
  
  RESULTS
  The PAD program contributed for the further improvement of ABT, and the number of participating patients increased, especially in the period 2002-2003, when the idea of PAD program implementation came out. By simple extrapolation of the ABT data to allogeneic blood, ABT was found to be superior in terms of cost-effectiveness. However, problems such as the high wastage rate, and the inappropriate transfusion triggers remain to be solved.
  
  
  CONCLUSIONS
  ABT plays the central role in PBM, but to achieve the real PBM, there is need to indicate ABT appropriately, according to the individual needs, and use it adequately, without discarding. Our present data reflect the present status of the ABT performance in Japan, and will serve as the basis for the development of strategies to achieve safe and appropriate performance of ABT, and consequently, achieve PBM.
authors.affiliation: Department of Transfusion Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: tsuno-tky@umin.net.
authors.forename: Nelson Hirokazu
authors.initials: NH
authors.lastname: Tsuno
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nagura
authors.forename: Michiru
authors.initials: M
authors.lastname: Kawabata
authors.forename: Mika
authors.initials: M
authors.lastname: Matsuhashi
authors.forename: Shinji
authors.initials: S
authors.lastname: Sone
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Naoko
authors.initials: N
authors.lastname: Okochi
authors.forename: Koki
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001782:Blood Donors / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000191:economics / Q000379:methods*; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D055815:Young Adult
keywords: Autologous blood transfusion; Patient blood management; Pre-deposit autologous blood donation program