Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.

輸血療法の適正化,即ち Type and Screen と自己血輸血の導入にむけての当院における輸血検査の再評価

林 久智 岡山大学医学部付属病院輸血部
小郷 博昭 岡山大学医学部付属病院輸血部
渡部 俊幸 岡山大学医学部付属病院中央検査部
松永 智恵子 岡山大学医学部付属病院輸血部
Thumnail 102_921.pdf 5.33 MB
Between April 1984 and March 1989, anti-erythrocyte irregular antibodies (Abs) were detected in 329 (4.0%) of 8, 208 patients by a screening test using saline, bromelin and Coombs' methods. Most of them were anti-P(1), Lewis, M, Rh-D, -E, and -c Abs. Of the detected Abs, 174 were reactive at 37°C, with 79 Abs (45.4%), 131 Abs (75.3%) and 150 Abs (86.2%) being detected by the saline, bromelin and Coombs' methods, respectively. Our Ab screening test was found to be 99.99 per cent effective in preventing the transfusion of incompatible blood. We also examined blood utilization during surgery for 28 different types of elective operation in 1976 patients. By analysis of the results of this examination, it was possible to decide on preoperative crossmatch guidelines, i.e. a maximum surgical blood order schedule, for 9 operations in abdominal surgery, 2 in lung surgery, 5 in cardiac surgery, 2 in neurosurgery, 2 in orthopedic surgery and 1 in gynecologic surgery. Arrangements for blood transfusion were unnecessary for cholecystectomy and 6 other operations, but the introduction of “type and screen” appears to be the best way to avoid an urgent order from the surgeon and for improvement in blood availability.
type and screen
MSBOS (maximum surgical blood order schedule)
anti-erythrocyte irregular antibody
blood transfusion