大分医科大学，宮崎医科大学附属病院における血液製剤使用適正化への取り組み

Abstract

We conducted a blood products utilization review in Oita Medical University Hospital (Oita) and Miyazaki Medical College Hospital (Miyazaki) before and after revision of the Japanese Guideline for Appropriate Usage of Blood Products. During the period from April 1998 to September 2001, the usage of red blood cells (RC-MAP), fresh frozen plasma (FFP), platelet concentrate (PC) and autologous blood in both hospitals was concurrently analyzed. Usage of RC-MAP and PC were reduced by about 30% and 10-15%, respectively, in both hospitals during the study period. A greater than 60% reduction in FFP usage was achieved in Oita as compared to 14% in Miyazaki. In surgical departments, the decrease in RC-MAP and FFP usage was similar in the two hospitals. In internal medicine departments, however, a greater than 80% reduction in FFP usage was observed in Oita. The ratio of autologous red cells to all red cells transfused during operation was increased to more than 30% in Miyazaki. The activities of blood transfusion committees for the education of doctors as well as the computer ordering programs justified by the blood coagulation data seem to have been effective in eliminating unnecessary FFP transfusion, especially in Oita. These results indicate that activities undertaken to inform and promote the new Japanese Guideline for blood transfusion have been successful in producing an overall improvement in transfusion practice in both university hospitals, especially with regard to decreasing FFP usage in Oita and increasing autologous blood usage in Miyazaki.