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Kim OS, Ji S, Jung HW, Matthews SA, Cha YJ, Moon SD, Kim K. Future Blood Debt: Projecting Blood Supply and Demand of Korea Based on Subnational Population Projections (2021-2050). J Korean Med Sci 2024; 39:e168. [PMID: 38804012 PMCID: PMC11136676 DOI: 10.3346/jkms.2024.39.e168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND South Korea faces a critical challenge with its rapidly declining fertility rates and an increasingly aging population, which significantly impacts the country's blood supply and demand. Despite these nationwide trends, regional disparities in blood supply and demand have not been thoroughly studied. METHODS This research utilized blood donation data from the Korean Red Cross and blood transfusion data from the Health Insurance Review and Assessment Service. We analyzed these datasets in conjunction with regional population projections to simulate blood supply and demand from 2021 to 2050 across South Korea. Sensitivity analyses were conducted to assess the impact of various factors, including the number of donors, age eligibility criteria for donations, frequency of donations, and blood discard rates. RESULTS Our projections indicate a decreasing trend in blood supply, from 2.6 million units in 2021 to 1.4 million units by 2050, while demand is expected to peak at 5.1 million units by 2045 before declining. Metropolitan areas, particularly Gyeonggi Province, are projected to experience the most severe shortages. Sensitivity analyses suggest that increasing the donation frequency of existing donors and relaxing age eligibility criteria are more effective strategies in addressing these imbalances than merely increasing the number of new donors. Blood discard rates showed minimal impact on the overall blood shortage. CONCLUSION The findings emphasize the urgent need for targeted strategies to mitigate national and regional blood supply shortages in South Korea. Encouraging frequent donations from experienced donors and broadening eligibility criteria are critical steps toward stabilizing the blood supply amidst demographic shifts. These strategies must be prioritized to address the impending regional disparities in blood availability.
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Affiliation(s)
- Oh Seok Kim
- Department of Geography, Graduate School of Korea University, Seoul, Korea
- Department of Geography Education, College of Education, Korea University, Seoul, Korea
- Institute of Future Land, Korea University, Korea University, Seoul, Korea.
| | - Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Stephen A Matthews
- Department of Sociology and Criminology, Penn State University, University Park, PA, USA
- Department of Anthropology, Penn State University, University Park, PA, USA
| | - Young Joo Cha
- Corporate R&D Center for Biological Standards and Control, Resources and Innovation Cooperative, Hanam, Korea
| | - Sung Do Moon
- Department of Internal Medicine, Hospital Medicine Center, Seoul National University Hospital, Seoul, Korea
| | - KeeWhan Kim
- Department of Big Data Science, Korea University, Sejong, Korea
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Fung YL, Alcantara RM, Cavalli LB, Chen JW, Chen YY, Donkin R, Kupatawintu P, Kwon SY, Lee CK, Nadarajan VS, Namjil E, Bat S, Odajima T, Sachdev S, Siswishanto R, Tadsomboon S, Sharma RR, Triyono T, Tsuno NH. Insights into the diversity of blood donation practice across Asia: How blood collection agencies adapt donor criteria and processes to their population. Vox Sang 2023; 118:1046-1060. [PMID: 37753662 DOI: 10.1111/vox.13530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Securing an adequate blood supply relies on accurate knowledge of blood donors and donation practices. As published evidence on Asian populations is sparse, this study aims to gather up-to-date information on blood donors and donation practices in Asia to assist planning and strategy development. MATERIALS AND METHODS Ten blood collection agencies (BCAs) provided 12 months' data on donors who met eligibility criteria or were deferred, as well as details of their donation practices. Body mass index and blood volumes were calculated and analysed. RESULTS Data on 9,599,613 donations and 154,834 deferrals from six national and four regional BCAs revealed varied donation eligibility and collection practices. Seven used haemoglobin (Hb) criteria below the World Health Organization anaemia threshold. Seven accepted donors weighing <50 kg. Data collection on the weight and height of donors and on deferrals was inconsistent, often not routine. Deferred donors appear to weigh less, with corresponding lower estimated blood volume. CONCLUSION The diversity in eligibility criteria and donation practices reflects each BCA's strategy for balancing donor health with securing an adequate blood supply. Use of lower Hb criteria substantiate their appropriateness in Asia and indicate the need to define Hb reference intervals relevant to each population. We encourage routine gathering of donor weight and height data to enable blood volume estimation and local optimization of donation volumes. Blood volume estimation formulae specific for the Asian phenotype is needed. Information from this study would be useful for tailoring donation criteria of Asian donors around the world.
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Affiliation(s)
- Yoke-Lin Fung
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | | | | | - Jen-Wei Chen
- Taiwan Blood Services Foundation, Taipei City, Taiwan
| | - Yun-Yuan Chen
- Taiwan Blood Services Foundation, Taipei City, Taiwan
| | - Rebecca Donkin
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Birtinya, Queensland, Australia
| | - Pawinee Kupatawintu
- National Blood Centre, Thai Red Cross Society, Thai National Stem Cell Donor Registry (TSCDR), Bangkok, Thailand
| | - So-Yong Kwon
- Blood Safety Bureau, Blood Services Headquarters, Korean Red Cross, Wonju-si, Gangwon-do, Republic of Korea
| | - Cheuk-Kwong Lee
- Hong Kong Red Cross Blood Transfusion Services, Kowloon, Hong Kong SAR, China
| | | | - Erdenebayar Namjil
- National Center for Transfusion Medicine, Ministry of Health, Mongolian Red Cross Society, Ulaanbaatar, Mongolia
| | - Solongo Bat
- National Center for Transfusion Medicine, Ministry of Health, Mongolian Red Cross Society, Ulaanbaatar, Mongolia
| | - Takeshi Odajima
- Japanese Red Cross, Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - Suchet Sachdev
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Sahit Tadsomboon
- National Blood Centre, Thai Red Cross Society, Thai National Stem Cell Donor Registry (TSCDR), Bangkok, Thailand
| | - Ratti Ram Sharma
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Teguh Triyono
- Sardjito Hospital, Gadjah Mada University, Yogyakarta, Indonesia
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Dorle A, Gajbe U, Singh BR, Noman O, Dawande P. A Review of Amelioration of Awareness About Blood Donation Through Various Effective and Practical Strategies. Cureus 2023; 15:e46892. [PMID: 37954754 PMCID: PMC10638672 DOI: 10.7759/cureus.46892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Blood donations play a crucial role in medical care; however, the global shortage of donors remains and has a serious impact on medical interventions. The challenges involved include the lack of public awareness of the importance of blood donation, the lack of understanding of the process and eligibility criteria for blood donation, and the lack of comprehensive strategies aimed at raising awareness and participation among potential donors, with particular emphasis on the involvement of young people. It is essential to recognize that blood donation delivers significant benefits to donors and recipients, improves overall health, and ultimately saves lives. Various initiatives, such as blood donation camps, dynamic social media campaigns, and strategic networking of medical professionals, have proved effective in promoting blood donation. In particular, in the event of an emergency, the availability of sufficient blood supplies is increasingly essential, underlining the urgent need to establish and maintain a sustainable blood donor network. An in-depth understanding of the motivation and conservation of donors is crucial in this context, as it is known that demographic factors significantly impact the frequency of blood donation. In addition, ethical and legal considerations require careful attention, highlighting the essential role of obtaining informed consent and ensuring the confidentiality of donors throughout the process. As we look ahead to the evolving landscape, it presents a series of formidable challenges. These challenges encompass the critical necessity to broaden and diversify our donor base, thereby extending and varying our sources of financial support for specific initiatives, organizations, or projects. Moreover, we must proactively harness the opportunities presented by emerging technologies and commit ourselves to closing the information gaps within the existing public knowledge sphere. In summary, the review emphasizes the paramount importance of ongoing efforts to strengthen and enrich donors' engagement through customized strategies and educational outreach.
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Affiliation(s)
- Akshay Dorle
- Pathology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Ujwal Gajbe
- Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Brij Raj Singh
- Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Obaid Noman
- Pathology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Pratibha Dawande
- Pathology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
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Cho YK, Kim HK, Kwon SS, Jeon SH, Cheong JW, Nam KT, Kim HS, Kim S, Kim HO. In vitro erythrocyte production using human-induced pluripotent stem cells: determining the best hematopoietic stem cell sources. Stem Cell Res Ther 2023; 14:106. [PMID: 37101221 PMCID: PMC10132444 DOI: 10.1186/s13287-023-03305-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/28/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Blood transfusion is an essential part of medicine. However, many countries have been facing a national blood crisis. To address this ongoing blood shortage issue, there have been efforts to generate red blood cells (RBCs) in vitro, especially from human-induced pluripotent stem cells (hiPSCs). However, the best source of hiPSCs for this purpose is yet to be determined. METHODS In this study, hiPSCs were established from three different hematopoietic stem cell sources-peripheral blood (PB), cord blood (CB) and bone marrow (BM) aspirates (n = 3 for each source)-using episomal reprogramming vectors and differentiated into functional RBCs. Various time-course studies including immunofluorescence assay, quantitative real-time PCR, flow cytometry, karyotyping, morphological analysis, oxygen binding capacity analysis, and RNA sequencing were performed to examine and compare the characteristics of hiPSCs and hiPSC-differentiated erythroid cells. RESULTS hiPSC lines were established from each of the three sources and were found to be pluripotent and have comparable characteristics. All hiPSCs differentiated into erythroid cells, but there were discrepancies in differentiation and maturation efficiencies: CB-derived hiPSCs matured into erythroid cells the fastest while PB-derived hiPSCs required a longer time for maturation but showed the highest degree of reproducibility. BM-derived hiPSCs gave rise to diverse types of cells and exhibited poor differentiation efficiency. Nonetheless, erythroid cells differentiated from all hiPSC lines mainly expressed fetal and/or embryonic hemoglobin, indicating that primitive erythropoiesis occurred. Their oxygen equilibrium curves were all left-shifted. CONCLUSIONS Collectively, both PB- and CB-derived hiPSCs were favorably reliable sources for the clinical production of RBCs in vitro, despite several challenges that need to be overcome. However, owing to the limited availability and the large amount of CB required to produce hiPSCs, and the results of this study, the advantages of using PB-derived hiPSCs for RBC production in vitro may outweigh those of using CB-derived hiPSCs. We believe that our findings will facilitate the selection of optimal hiPSC lines for RBC production in vitro in the near future.
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Affiliation(s)
- Youn Keong Cho
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Kyung Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soon Sung Kwon
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su-Hee Jeon
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - June-Won Cheong
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ki Taek Nam
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Han-Soo Kim
- Department of Biomedical Sciences, Catholic Kwandong University College of Medical Convergence, Gangneung-si, Gangwon-do, Republic of Korea
| | - Sinyoung Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Hyun Ok Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Kim HO. Current State of Blood Management Services in Korea. Ann Lab Med 2022; 42:306-313. [PMID: 34907100 PMCID: PMC8677471 DOI: 10.3343/alm.2022.42.3.306] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/10/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022] Open
Abstract
Blood is lifesaving; however, it can neither be limitlessly acquired nor artificially produced. The supply and use of blood, as an invaluable biological commodity, necessitate systematic and rational management under governmental guidance to ensure safe and reliable transfusions. Despite Korea’s blood donation rate of 5.04%, which is higher than the 3.15% in high-income countries as reported by the WHO, the demand for blood exceeds the availability. This is due to the birthrate decline, dearth of young donors, and growing and aging recipient population. This review outlines the Korean blood management system, with a focus on blood service data from 2020, with the aim to delineate the current state of Korea’s blood management system and the policies established to address the imminent blood shortage. Each policy is described in detail to provide helpful information for blood management services in other countries.
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Affiliation(s)
- Hyun Ok Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
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Arnason NA, Johannsson F, Landrö R, Hardarsson B, Gudmundsson S, Lian AM, Reseland J, Rolfsson O, Sigurjonsson OE. Protein Concentrations in Stored Pooled Platelet Concentrates Treated with Pathogen Inactivation by Amotosalen Plus Ultraviolet a Illumination. Pathogens 2022; 11:pathogens11030350. [PMID: 35335674 PMCID: PMC8954553 DOI: 10.3390/pathogens11030350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
Platelet granules contain a diverse group of proteins. Upon activation and during storage, platelets release a number of proteins into the circulation or supernatant of stored platelet concentrate (PC). The aim of this work was to investigate the effect of pathogen inactivation (PI) on a selection of proteins released in stored platelets. Materials and Methods: PCs in platelet additive solution (PAS) were produced from whole blood donations using the buffy coat (BC) method. PCs in the treatment arm were pathogen inactivated with amotosalen and UVA, while PCs in the second arm were used as an untreated platelet control. Concentrations of 36 proteins were monitored in the PCs during storage. Results: The majority of proteins increased in concentration over the storage period. In addition, 10 of the 29 proteins that showed change had significantly different concentrations between the PI treatment and the control at one or more timepoints. A subset of six proteins displayed a PI-related drop in concentration. Conclusions: PI has limited effect on protein concentration stored PC supernatant. The protein’s changes related to PI treatment with elevated concentration implicate accelerated Platelet storage lesion (PSL); in contrast, there are potential novel benefits to PI related decrease in protein concentration that need further investigation.
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Affiliation(s)
- Niels Arni Arnason
- The Blood Bank, Landspitali-The National University Hospital of Iceland, 105 Reykjavik, Iceland; (N.A.A.); (R.L.); (B.H.); (S.G.)
- School of Engineering, Reykjavik University, 105 Reykjavik, Iceland
| | - Freyr Johannsson
- Department of Medicine, University of Iceland, 105 Reykjavik, Iceland; (F.J.); (O.R.)
| | - Ragna Landrö
- The Blood Bank, Landspitali-The National University Hospital of Iceland, 105 Reykjavik, Iceland; (N.A.A.); (R.L.); (B.H.); (S.G.)
| | - Björn Hardarsson
- The Blood Bank, Landspitali-The National University Hospital of Iceland, 105 Reykjavik, Iceland; (N.A.A.); (R.L.); (B.H.); (S.G.)
| | - Sveinn Gudmundsson
- The Blood Bank, Landspitali-The National University Hospital of Iceland, 105 Reykjavik, Iceland; (N.A.A.); (R.L.); (B.H.); (S.G.)
| | - Aina-Mari Lian
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, 0317 Oslo, Norway; (A.-M.L.); (J.R.)
| | - Janne Reseland
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, 0317 Oslo, Norway; (A.-M.L.); (J.R.)
| | - Ottar Rolfsson
- Department of Medicine, University of Iceland, 105 Reykjavik, Iceland; (F.J.); (O.R.)
| | - Olafur E. Sigurjonsson
- The Blood Bank, Landspitali-The National University Hospital of Iceland, 105 Reykjavik, Iceland; (N.A.A.); (R.L.); (B.H.); (S.G.)
- School of Engineering, Reykjavik University, 105 Reykjavik, Iceland
- Correspondence: ; Tel.: +354-543-5523 or +354-694-9427; Fax: +354-543-5532
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Kim H, Shin KH, Kim HH, Lee HJ. Perceptions and Experiences of Migrants in Korea Regarding Blood Donation in Association with Sociodemographic Status. Ann Lab Med 2022; 42:258-267. [PMID: 34635617 PMCID: PMC8548250 DOI: 10.3343/alm.2022.42.2.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/11/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
Background With increasing number of migrants in Korea, there is an increasing need for blood products with rare blood antigens. Accordingly, the role of blood donors among migrants has been acknowledged. We investigated migrants’ experiences and perceptions of blood donation along with their sociodemographic status and identified the effects on self-reported blood donation status. Methods A cross-sectional survey using a self-developed, structured questionnaire was conducted on 479 migrants. The questionnaire included items about experiences, knowledge, and perceptions on blood donation and sociodemographic factors of respondents. Results Most migrants in this study were from Southeast Asia (54.7%) or China (39.9%). Among them, 28.6% (N=137) had donated blood previously, and 2.7% (N=13) had previously donated blood in Korea. All previous blood donors were volunteers, and the two major deterrents of blood donation for non-donors were the fear of pain and lack of knowledge about blood donation. In multivariable logistic regression analysis, the country of birth (odds ratio [OR]=2.65, P<0.001 [China]; OR=4.85, P=0.001 [countries other than China and Southeast Asian countries]) and employment status (OR=2.80, P=0.034) were independently associated with blood donation. Conclusions This is the first Korean study to analyze migrants’ experiences and perceptions of blood donation in relation to their sociodemographic status. Our findings can help establish blood donation policies for migrants, devise campaigns to enhance blood donation awareness, and ultimately create a pool of rare blood resources in a multicultural society.
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Affiliation(s)
- Hyerin Kim
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Korea
| | - Kyung-Hwa Shin
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Korea
| | - Hyung-Hoi Kim
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Korea.,Biomedical Informatics Unit, Pusan National University Hospital, Busan, Korea
| | - Hyun-Ji Lee
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Shin HJ, Kim JH, Park Y, Ahn KH, Jung JS, Park JH. Effect of patient blood management system and feedback programme on appropriateness of transfusion: An experience of Asia's first Bloodless Medicine Center on a hospital basis. Transfus Med 2020; 31:55-62. [PMID: 33368693 DOI: 10.1111/tme.12754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/17/2020] [Accepted: 12/17/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Patient blood management (PBM) programmes minimise red blood cell (RBC) transfusion and improve patient outcomes worldwide. This study evaluated the effect of a multidisciplinary, collaborative PBM programme on the appropriateness of RBC transfusion in medical and surgical departments at a hospital level. METHODS/MATERIALS In 2018, the revised PBM programme was launched at the Korea University Anam Hospital, a tertiary hospital with 1048 hospital beds and the first Asian institution where a new computer PBM programme was implemented. Monthly RBC usage and adequacy were analysed from January 2018 to December 2019. The trend of adequacy over time was assessed. RESULTS A total of 2 201 021 patients were hospitalised and visited an outpatient clinic. The number of RBC units transfused per 10 000 patients decreased from 139.8 for 2018 to 137.3 for 2019. The proportion of patients with Hb <7 g/dL receiving RBC transfusion increased significantly: 29.1%, 34.5%, 40.4% and 40.6% for periods 1, 2, 3 and 4, respectively (p < 0.001). The appropriateness of RBC transfusion significantly increased for medical (35.2%, 41.5%, 49.6% and 74.3% for periods 1, 2, 3 and 4, respectively [p < 0.001]) and surgical (37.8%, 33.3%, 45.5% and 71.1% for periods 1, 2, 3 and 4, respectively [p < 0.001]) departments. CONCLUSION Implementation of a PBM programme through a multidisciplinary clinical community approach increased the appropriateness of RBC transfusion in medical and surgical departments. Therefore, expanding publicity and PBM education to health care providers is important to maintain the appropriateness of blood transfusion.
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Affiliation(s)
- Hyeon Ju Shin
- Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Jong Hun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yujin Park
- Bloodless Medicine Center, Korea University Anam Hospital, Seoul, South Korea
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea
| | - Jae Seung Jung
- Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Seoul, South Korea
| | - Jong Hoon Park
- Department of Orthopedic Surgery, Korea University College of Medicine, Seoul, South Korea
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