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Management system of home transfusion in Japan: A nationwide survey in 2019
Asashi Tanaka1, Hiroshi Fujita2, Kota Ohashi3
1Department of Clinical Laboratory Medicine and Department of Transfusion Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
Insights
Home transfusions in Japan are in the developing phase, with no serious reactions reported. Increased hospital-clinic cooperation is key to improving safety and availability for patients receiving red blood cells (RBCs) at home.
Area of Science:
- Medical Science
- Hematology
- Healthcare Management
Background:
- Home transfusion practices in Japan face safety concerns.
- Limited data exists on the safety and availability of home transfusions in Japan.
Purpose of the Study:
- To investigate the safety and availability of home transfusions in Japan.
- To understand the current state of home transfusion services.
Main Methods:
- Survey of 51 Japanese clinics providing home care and transfusion experience.
- Analysis of clinic collaboration, red blood cell (RBC) storage, and patient management systems.
- Data collected from February to December 2019.
Main Results:
- 17.6% of home care clinics perform home transfusions, primarily in urban areas.
- Half of clinics collaborate with hospitals for emergencies; RBCs often stored in non-dedicated refrigerators.
- No serious transfusion reactions reported in 150 patients (2019) or 623 patients (up to 2018).
Conclusions:
- Home transfusions in Japan are currently in a developing phase.
- Enhanced collaboration between hospitals and clinics is essential for system improvement.
- The practice shows promise for safe patient care with proper management.
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.
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