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Background: Japan, where the elderly population is increasing rapidly while the younger generations are in state of decrease, is anticipated in the near future to experience a shortage of blood components as the demand for blood transfusions will correspondingly expand. This survey was performed in order to establish countermeasures to use blood components efficiently through analyzing those factors which contribute to good utilization. Method: A questionnaire was sent to 131 hospitals in Fukushima Prefecture inquiring as to their use of whole blood/blood components between April, 1999 and March, 2000. Results: Among 96 institutions, 32 (33%), 44 (46%), or 45 (47%) had a transfusion committee, a blood transfusion division, or a doctor responsible for transfusions, respectively. Discard ratios were 7.9% (6,492/82,348 units) for red cells, and 0.6% (405/68,284 units) for fresh frozen plasma. However, through the establishment of a transfusion committee, a transfusion division, or a responsible doctor, the discard ratio of red cells decreased: Corresponding odds ratios were 0.6, 0.36, or 0.53, respectively. Conversely, the introduction of MSBOS had minimal effect in reducing discarded red cells (odds ratio: 0.89). Conclusion: For the optimal use of blood components, the establishment of a transfusion division plays a key role, and accordingly, such a practice should be expanded nationwide.

Intra-institutional establishment of blood transfusion systems as the most efficient contributors in reducing discarded blood components.