[The current state of transfusion medicine in Japan]

In Japan, transfusion medicine, which is supported by the voluntary blood donation system, is facing a risk of blood shortage. This is due to reduced donations by the younger generation as well as the falling birth rate and the aging of the population, with a consequent increase in the elderly population that depends on blood transfusions for conditions such as cancer and hematological and cardiovascular diseases. Therefore, to guarantee stable provision of blood products, in addition to implementing measures to promote blood donation, healthcare professionals must, as a policy, strictly follow the rules for appropriate use of blood products as defined in the "Criteria for the Use of Blood Products". Additionally, measures such as the use of autologous blood to reduce allogeneic blood usage and the implementation of adequate internal control systems to reduce blood wastage should be considered. Further, although this is not presently covered by the Japanese Health Insurance System, cryoprecipitate or fibrinogen products, which are used as alternative therapies in cases of hypofibrinogenemia due to massive bleeding, are effective not only for reducing the blood transfusion volume, but also for alleviating bleeding in patients. Additionally, the use of erythropoietin to treat chemotherapy-induced anemia is an effective measure to improve patients' quality of life, and its prompt approval by the Health Insurance System is desired.