Management system of home transfusion in Japan: A nationwide survey in 2019

• Published in: Vox sanguinis Vol. 118; no. 1; pp. 59 - 67
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2023; S. Karger AG
• Subjects: Availability; blood storage; Blood Transfusion; collaboration system; Emergency medical services; Emergency preparedness; Emergency response; Erythrocyte Transfusion - adverse effects; Erythrocytes; home transfusion; Hospitals; Humans; Japan; Patients; Safety; Transfusion; transfusion management system; Transfusion Reaction - etiology; Urban areas; Japan; blood storage; collaboration system; transfusion management system; home transfusion
• ISSN: 0042-9007; 1423-0410
• DOI: 10.1111/vox.13380

Background and Objectives
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.
Materials and Methods
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.
Results
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.
Conclusion
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.