Survey of the current status of blood transfusion in remote areas in Japan

In Japan, remote areas have limited access to medical care due to geographical constraints. Additionally, some regions, although not classified as remote areas, have limited transfusion capacity because of their distance from blood centers. These are referred to as transfusion-access remote areas (t-remote areas). This study aimed to clarify transfusion practices in these regions.

A questionnaire was distributed in November 2024 to clinics located in remote areas and to clinics and hospitals in t-remote areas.

The questionnaire response rate was 35 % (290/823 clinics) in remote areas and 49 % (211/427 facilities) in t-remote areas. The median emergency transport time from blood centers to t-remote facilities was 70 min. Red blood cells were used in 3.1 % of remote area clinics, 87 % of t-remote area clinics, and 99 % of t-remote area hospitals. Emergency transfusions were performed in 0.3 %, 17 %, and 55 % of these facilities, respectively. Clinics generally transferred patients to other hospitals, whereas 67 % of t-remote area hospitals managed emergencies on-site. Blood products were not stored in clinics, whereas 36 % of t-remote area hospitals maintained red cell inventories, and 22 % requested blood rotation systems. Interfacility transfers were reported in 0.3 % of remote area clinics and approximately 6 % of t-remote area facilities, with about 20 % expressing a need for such a system. Fresh whole-blood transfusion was rare.

Overall, transfusion practices in remote area clinics were limited. In contrast, some t-remote area medical facilities require improved infrastructure to meet emergency transfusion demands.