• 제목/요약/키워드: Blood donation

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병원의 표준 혈액재고량 산출식 개발 (Development of the Standard Blood Inventory Level Decision Rule in Hospitals)

  • 김병익
    • Journal of Preventive Medicine and Public Health
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    • 제21권1호
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    • pp.195-206
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    • 1988
  • Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation has gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better.' The shortage itself by no means unnecessitate inventory control. In fact, in spite of shortage, no small amount of blood is outdated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this tudy is to develop formulae forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study informations of $A^+$ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated.48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measures of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of the issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study' were as follows ; 1. The formulae to calculate the standard blood inventory level($S^*$)was $S^*=2.8617X(d)^{0.9342}$ where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performace - outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level - were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First In-First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.

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헌혈량 감소 원인분석 (Analysis of causes of decrease in blood donation)

  • 김성진;조민호
    • 한국컴퓨터정보학회:학술대회논문집
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    • 한국컴퓨터정보학회 2023년도 제67차 동계학술대회논문집 31권1호
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    • pp.159-160
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    • 2023
  • 본 논문에서는 헌혈의 중요성과 지속적인 헌혈량 감소의 개선방안을 목적으로 하며, 헌혈량이 지속해 감소하는 이유에 대하여 분석하였다. 헌혈량은 코로나와 고령화 사회로 인한 헌혈의 주 연령층인 10대와 20대의 감소로 인해 헌혈량이 감소하는 상황이다. 이러한 문제를 확인하고 개선하기 위해 어떤 방법이 있는지 확인해 보았으며 분석 결과 고 연령층의 헌혈량은 증가하였지만, 헌혈의 주 연령층인 10대와 20대의 헌혈량을 대체하지 못하기 때문에 헌혈량은 연도가 지날 때마다 감소하는 추세를 확인할 수 있었다. 거기에 2019년 말부터 시작된 코로나로 인해 조금씩 감소하던 헌혈량을 더 큰 폭으로 감소하게 했다. 앞으로도 고령화 사회가 이어진다면 고연령층의 증가로 수혈은 필요하지만, 헌혈량이 따라가지 못하는 상황이 일어날 것으로 예측된다.

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뇌사와 장기기증 및 장기이식에 대한 간호학생의 지식과 태도 연구 (A Study on Nursing College Students' Knowledge and Attitudes toward Brain Death, Organ Donation and Organ Transplantation)

  • 강희영
    • 한국간호교육학회지
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    • 제5권1호
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    • pp.7-19
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    • 1999
  • The purpose of this study was to examine nursing college students' knowledge of and attitudes toward brain death, organ donation and organ transplantation. The research design utilized in this study was a descriptive research design. The data were collected from September 7 to 14, 1998, by means of strutted questionnaire. To measure students' knowledge of brain death, organ donation and organ transplantation, Joo's(1995) instrument was used. The questionnaire was composed of 22 items. To measure students' attitudes toward organ donation and organ transplantation, s(1995) Instrument was used. The questionnaire was composed of 22 items. The data were analyzed by frequency, t-test, ANOVA, and Pearson's Correlation Coefficient using the SAS program. The results were as follows : 1. Students' knowledge of brain death, organ donation and organ transplantation was 9-20. The mean score was 15.36, with 22, the highest possible score. There was statistically significant difference between students' knowledge and approval on the brain death recognition group(t=9.75, p=0.002). 2. Students' altitudes toward organ do nation and organ transplantation showed is mean score of 3.61 on a 5 attitudes points Liken scale. More than 80% of respondents agreed that organ transplantation can offer a high quality of life to the recipient and is an acceptable form of medical treatment. The health care costs associated with organ transplantation are worth itif another's life can be saved. Students felt it important to help others who are very ill. Also, by donating organs, students felt a part of their own body would continue to live by making it possible for someone else to live. Only 2.9% of students objected to organ donation for religious reasons. There was statistically significant difference among students' attitudes, experienced blood donor group(t=17.04, p=0.000), approval on the brain death recognition group (t=21.06, p=0.000), organ donation agreement group(t=46.13, p=0.000).

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순환정지 후 장기기증의 의료윤리적 문제 (Medical ethical problems of organ donation after circulatory death)

  • 박순호;허정식;김기영
    • Journal of Medicine and Life Science
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    • 제17권3호
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    • pp.74-79
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    • 2020
  • It is necessary to expand organ donations of the deceased, as more ethical problems are emerging from the increase in organ donations from the living. As the legal and ethical discussions on donation after circulatory death (DCD) as a field with the potential to expand such domestic organ donation are being held, the need for a social consensus is increasingly highlighted. Organ DCD refers to the donation of an organ from a patient whose spontaneous blood circulation has stopped due to cardiac death. In this study, we aimed to examine whether there are legal and ethical obstacles or medical uncertainties for expanding the practice of DCD. By law, death is recognized as cardiac death, and brain death is recognized as an exception for organ transplantation. Although circulatory death precedes brain death, this paper presents a discussion to begin the process of reaching an ethical and legal agreement on whether or not circulatory death can be recognized as death. Successful implementations of DCD, including Category III DCD, in other countries are currently being reviewed to introduce Category III DCD in Korea.

Effects of Preoperative Autologous Blood Donation in Patients Undergoing Minimally Invasive Cardiac Surgery

  • Lim, Mi Hee;Je, Hyung Gon;Ju, Min Ho;Lee, Ji Hye;Oh, Hye Rim;Kim, Ye Ri
    • Journal of Chest Surgery
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    • 제52권6호
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    • pp.385-391
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    • 2019
  • Background: Preoperative autologous blood donation (PABD) is a conservation strategy for reducing allogenic blood transfusion (ABT) during minimally invasive cardiac surgery (MICS). We aimed to evaluate the effects of PABD on the frequency of ABT and clinical outcomes in patients undergoing MICS. Methods: We enrolled 113 patients (47.8±13.1 years, 50 men) undergoing MICS without preoperative anemia (hemoglobin >11 g/dL) between 2014 and 2017. Of these patients, 69 (the PABD group) donated autologous blood preoperatively and were compared to the non-PABD group (n=44). We analyzed the frequency of perioperative ABT and clinical outcomes. Results: Baseline characteristics did not significantly differ between groups, although preoperative hemoglobin levels were lower in the PABD group. All operations were performed using a minimally invasive approach. Patients' surgical profiles were similar. There were no cases of mortality or significant differences in early postoperative outcomes. During the early postoperative period, hemoglobin levels were higher in the PABD group. No significant difference was found in the frequency of ABT. Conclusion: Although the PABD group had higher postoperative hemoglobin levels, there was no clear clinical benefit in the early postoperative period, despite a great deal of effort and additional cost. Additional PABD in the setting of strict policies for blood conservation was ineffective in reducing ABT for young and relatively healthy patients who underwent MICS.

헌혈이 헌혈자의 혈유변학적 지표에 미치는 영향 (Effect of Blood Donation on the Donor's Hemorheological Properties)

  • 이병권
    • 대한수혈학회지
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    • 제29권3호
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    • pp.229-239
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    • 2018
  • 순환계는 혈액의 흐름이 원활하게 되도록 그 해부학적 구조와 혈류의 물리학적 특성이 연결되어있다. 혈액의 흐름에 영향을 주는 혈액의 물리학적 특성을 혈유변학적 인자(Hemorheologic factors)라 하며, 혈액의 점도(blood viscosity) 및 적혈구 응집도(erythrocyte aggregation)와 같은 혈유변학적 특성은 헤마토크리트(hematocrit; Hct)와 밀접한 관계를 가진다. 헤마토크리트가 높을수록 혈액 점도가 증가하고 적혈구 응집도는 증가하며 순환을 저해하고 조직에 산소 전달 능력을 방해한다. 혈청 페리틴은 과도하게 있을 경우 산화유리기(oxygen free radial)를 통하여 혈관 내피세포(vascular endothelial cell)와 혈구 세포(blood cell)에 산화 손상을 유발하여 심혈관계 손상을 유발한다. 이러한 기전을 근거로 사혈 혹은 헌혈을 심혈관계 질환의 예방 및 치료에 응용하려는 시도가 오랫동안 있었다. 사혈은 의학에 있어 오랜 역사를 가지면서 특히 한방의 치료적 개념으로 최근까지도 사용되고 있으나 그 과학적 근거가 불충분하고 아직까지 논란의 여지도 있어 근거 중심의 의학을 근간으로 하는 의학에서는 도외시되어왔다. 하지만 혈액량이 증가하면 혈유변학적 인자들(hemorheological factors) 역시 악화되면서 대 순환에서 동맥경화의 발생 및 진행에 영향을 주고, 모세순환(microcirculation)을 악화시키는 것으로 알려져 있으며 심뇌혈관 사건에 영향을 주는 것으로 보고되고 있다. 정기적인 헌혈자(regular blood donors)에게 혈유변학적 인자들을 저명하게 호전시키고 과도한 철분의 함량을 줄여서 산화유리기에 의한 혈구 및 내피세포의 산화 손상을 줄임으로써, 순환계내에서 혈액순환을 촉진시킬 수 있다는 증거들이 보고되고 있다. 헌혈의 효과가 심혈관계 질환에 이익이 된다는 확고한 장기적 코호트 연구결과가 도출된다면 절대적으로 헌혈 혈액량이 부족한 현실과 심혈관계 질환의 예후를 호전시킬 수 있다는 측면에서 중요한 역할을 할 수 있다고 생각된다.

Maternal and fetal outcomes of pregnancies in kidney donors: A 30-year comparative analysis of matched non-donors in a single center

  • Yoo, Kyung Don;Lee, Hajeong;Kim, Yaerim;Park, Sehoon;Park, Joong Shin;Hong, Joon Seok;Jeong, Chang Wook;Kim, Hyeon Hoe;Lee, Jung Pyo;Kim, Dong Ki;Oh, Kook-Hwan;Joo, Kwon Wook;Kim, Yon Su
    • Kidney Research and Clinical Practice
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    • 제37권4호
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    • pp.356-365
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    • 2018
  • Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.

제대혈 기증.보관한 산부의 제대혈 관련 지식 및 태도 (Knowledge and Attitude Regard to Cord Blood of Early Postpartum Women after Donating Cord Blood or Storing Cord Blood)

  • 김미옥;유지수;박창기;안현미
    • 여성건강간호학회지
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    • 제15권1호
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    • pp.13-23
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    • 2009
  • Purpose: There is increasing necessity of using cord blood cell worldwide. In order to improve the effectiveness of cord blood's usage in Korea, the study of knowledge and attitude regarding cord blood is needed. Method: As descriptive correlation study, data was collected from 212 early postpartum women who stored or donated cord blood from 2007 April to July. Data was analyzed using $X^2$-test, t-test, ANOVA, and logistic regression. Result: Total score of knowledge and attitude of early postpartum women who donated cord blood was higher than who stored. According to the source of education and the source of influence toward decision of using cord blood, early postpartum women who educated or influenced by mass media showed difference in attitude. Job status and income, and attitude of cord blood were the predictor of cord blood donation. Conclusion: Attitude regard to cord blood affect to usage of cord blood, and the attitude and knowledge of cord blood in early postpartum women who donated it higher than who stored.

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Relationships between Skin Cancers and Blood Groups - Link between Non-melanomas and ABO/Rh Factors

  • Cihan, Yasemin Benderli;Baykan, Halit;Kavuncuoglu, Erhan;Mutlu, Hasan;Kucukoglu, Mehmet Burhan;Ozyurt, Kemal;Oguz, Arzu
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.4199-4203
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    • 2013
  • Background: This investigation focused on possible relationships between skin cancers and ABO/Rh blood groups. Materials and Methods: Between January 2005 and December 2012, medical data of 255 patients with skin cancers who were admitted to Kayseri Training and Research Hospital, Radiation Oncology and Plastic Surgery Outpatient Clinics were retrospectively analyzed. Blood groups of these patients were recorded. The control group consisted of 25701 healthy volunteers who were admitted to Kayseri Training and Research Hospital, Blood Donation Center between January 2010 and December 2011. The distribution of the blood groups of the patients with skin cancers was compared to the distribution of ABO/Rh blood groups of healthy controls. The association of the histopathological subtypes of skin cancer with the blood groups was also investigated. Results: Of the patients, 50.2% had A type, 26.3% had O type, 16.1% had B type, and 7.5% had AB blood group with a positive Rh (+) in 77.3%. Of the controls, 44.3% had A type, 31.5% had 0 type, 16.1% had B type, and 8.1% had AB blood group with a positive Rh (+) in 87.8%. There was a statistically significant difference in the distribution of blood groups and Rh factors (A Rh (-) and 0 Rh positive) between the patients and controls. A total of 36.8% and 20.4% of the patients with basal cell carcinoma (BCC) had A Rh (+) and B Rh (+), respectively, while 39.2% and 27.6% of the controls had A Rh (+) and B Rh (+), respectively. A significant relationship was observed between the patients with BCC and controls in terms of A Rh (-) (p=0.001). Conclusion: Our study results demonstrated that there is a significant relationship between non-melanoma skin cancer and ABO/Rh factors.