• Journal of Chest Surgery
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• v.45 no.5
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• pp.301-307
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• 2012

Background: Perioperative transfusion of red blood cell (RBC) may cause adverse effects. Bloodless-cardiac surgery has been spotlighted to avoid those problems. Off pump coronary artery bypass (OPCAB) surgery can decrease the transfusion. However, the risk factors of transfusions in OPCAB have not been investigated properly. Materials and Methods: One hundred and thirteen patients (male:female=35:78, mean age=$66.7{\pm}9.9$ years) who received isolated OPCAB were retrospectively analyzed from March 2006 to September 2007. The threshold of RBC transfusion was 28.0% of hematocrit. Bilateral internal thoracic arteries graft were used for 99 patients (87.6%). One hundred and three (91.1%) and 35 patients (31.5%) took aspirin and clopidogrel just before surgery. Results: Sixty-five patients (47.5%) received the RBC transfusion (mean $2.2{\pm}3.2$ units). Mortality and major complications were not different between transfusion and no-transfusion group. But, ventilator support time, intensive care unit stay and hospitalization period had been reduced in no-transfusion group (p<0.05). In multivariate analysis, patients risk factors for RBC transfusion were preoperative low hematocrit (<37.5%) and clopidogrel medication. Surgical risk factors were longer graft harvesting time (<75 minutes) and total operation time (<5.5 hours, p <0.05). Conclusion: We performed the transfusion according to transfusion guideline; over 40% cases could conduct the OPCAB without transfusion. There were no differences in major clinical results between transfusion and non-transfusion group. In addition, when used together with accurate understanding of transfusion risk factors, it is expected to increase the proportion of patients that do not undergo transfusions.

• Clinical and Experimental Pediatrics
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• v.61 no.9
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• pp.265-270
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• 2018

Neonates, especially extremely low birth weight infants, are among the groups of patients undergoing transfusion frequently. Since they are exposed to higher specific transfusion risks compared to the patients of other age groups, there are many special aspects that must be considered for transfusion therapy in neonates. The transfusion risks in neonates include adverse outcomes specific for preterm infants as well as increased metabolic, immunologic, and infectious complications. To reduce the risks of transfusion-transmitted cytomegalovirus infection and transfusion-associated graft-versus-host disease, leukoreduced and irradiated cellular blood products should be used for all neonates. This review summarizes the risks of neonatal transfusion therapy, specific methods to reduce risk, and current trends and practices of red blood cell and platelet transfusions in neonates, to facilitate decision-making for neonatal transfusion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.300-304
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• 1998

Moderns have desire likely to be further good-looking concomitant with a qualitative advancement of the life. With one of this phenomenon, an orthognathic surgery performing at the dept. of oral and maxillofacial surgery have been becoming a more extensively. It's possible to occur many complications during the operations and especially, an excessive bleeding of those may be fatal and so a transfusion is performing for the prevention &management of that. But, because of the rate of increase of an blood-born infection like AIDS via transfusion, nowadays an autologous blood transfusion is interesting to us. We made a comparative study of an amount of blood loss &transfusion using hemoglobin value after classifying the orthognathic surgeries from Feb. '97 to Mar. '98 in single-jaw and doublejaw surgery. And we intended to set a standard against of a routine preoperative cross-matching deciding the amount of predictive homologous blood transfusion according to operative method. Simultaneously, we studied the realization &effectiveness of autologous blood transfusion with some cases, so would like to present. Results: 1. Single-jaw operation can be performed without blood transfusion or with homologous blood transfusion through only blood typing & screening. 2. We commonly transfuse two units of blood with double-jaw operation and an autologous blood transfusion has much more advantage than an homologous blood transfusion. 3. We can reduce charge associated with blood transfusion through precisely preoperative evaluation of patients and proper type of blood transfusion.

• The Korean Journal of Blood Transfusion
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• v.23 no.2
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• pp.97-106
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• 2012

The Korean Society of Blood Transfusion (KSBT) was established in Seoul in 1982 by a group of physicians of clinical pathology (currently laboratory medicine), internal medicine, paediatrics, anaesthesiology, and surgery, who were members of the Korean Society of Hematology, in which they had been actively engaged as transfusion specialists. However, these physicians were dissatisfied with the lack of public recognition of blood transfusion and the unrealistic blood service system and therefore attempted to build an influential organization for improvement of blood services and transfusion medicine. The mission of the KSBT is to advance the science and practice of transfusion medicine. The KSBT advocates for education and research in the fields of transfusion medicine and for safe blood in blood services. The inaugural KSBT conference, with approximately 50 participants, was held in November, 1982; since then, annual conferences and educational workshops have been held regularly once or twice a year. Currently, the KSBT has approximately 800 members, who are practitioners of blood transfusion (holders of M.D.) or staff members of blood services (holders of other professional degrees). The Society also publishes the Korean Journal of Blood Transfusion (first issue published in 1990) and guidelines for blood services. A Society web site (http://www.transfusion.or.kr) was started in 2001, with the hope of increasingly providing information and feedback to members on a real-time basis. The KSBT has been an active participant in international activities. In 1995, the KSBT hosted the Sixth ISBT Western Pacific Regional Congress in Seoul and will host the $33^{rd}$ ISBT Congress in Seoul in 2014. Since its inauguration, the KSBT has had key roles not only in education and research in the fields of transfusion medicine but also in development of safe-blood services during the last 30 years.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.163-181
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• 2017

In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.

• Journal of Gastric Cancer
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• v.10 no.4
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• pp.196-205
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• 2010

Purpose: We did a retrospective study to understand the prognostic effects of preoperative blood transfusions in stomach cancer surgery. Materials and Methods: Data for 1,360 patients who underwent gastrectomy for stomach cancer between 2001 and 2009 were retrospectively reviewed. We analyzed factors that affect preoperative transfusion and clinicopathologic features. We also analyzed 5-year and overall survival rates of the transfusion and non transfusion subgroups. Results: Sixty patients (4.4%) required blood transfusion within the preoperative period. The transfused group included patients who took aspirin or clopidogrel (P<0.001), with more advanced T stages (P<0.001), with more advanced nodal metastasis (P=0.00), and with more advanced stages (P=0.00) than the non transfusion group. On multivariate analysis, preoperative transfusion was a statistically significant negative influence on 5-year survival and overall survival rates (58.2% vs 79.9% (P=0.00), 58.2% vs 76.8% (P=0.00)). Applying Cox-regression analyses, blood transfusion did appear to have an effect on prognosis and on 5-year and overall survival rates. Conclusions: We found a direct negative relation between preoperative transfusion and long term prognosis in patients receiving gastric cancer surgery.

• Journal of Medicine and Life Science
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• v.20 no.4
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• pp.172-177
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• 2023

This study assessed risk factors for blood transfusion after Cesarean section in patients with partial placenta previa. We retrospectively reviewed the medical records of 149 patients who underwent Cesarean sections for partial placenta previa between January 2010 and October 2021. Clinical characteristics were compared between the two groups: the blood transfusion group (n=22), defined as patients who received a blood transfusion during surgery or within 24 hours after surgery, and the non-blood transfusion group (n=127), which included other patients. Multivariable logistic regression analysis identified two risk factors independently associated with blood transfusion: antenatal hemorrhage (adjusted odds ratio [aOR], 16.283; 95% confidence interval [CI], 4.405-60.190; P<0.001) and preoperative hemoglobin (g/dL) (aOR, 0.427; 95% CI, 0.246-0.739; P=0.002). Thus, patients who are at risk for these two factors should be carefully managed with sufficient preparation for blood transfusion and anesthetic management.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.350-357
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• 2014

Background: Conservation of blood during cardiac surgery is important because of the shortage of donor blood, risks associated with transfusion, and the costs of allogeneic blood products. This retrospective study explored the feasibility of off-pump coronary artery bypass (OPCAB) without transfusion. Methods: One hundred and two consecutive patients underwent OPCAB from January 2007 to June 2012 at Hallym University Sacred Heart Hospital. Excluding 10 chronic renal failures patients, 102 patients were enrolled. Their characteristics, clinical data, and laboratory data were analyzed. We investigated the success rate of OPCAB without transfusion according to preoperative hemoglobin (Hb), and the cutoff point of the Hb level and the risk factors for transfusion. We implemented multidisciplinary blood-saving protocols. Results: The overall operative mortality and the success rate of OPCAB without transfusion were 2.9% (3/102) and 73.5% (75/102). The success rates in patients with Hb<11, 11 70 years, diagnosis of acute myocardial infarction, preoperative Hb and creatinine levels, and operation time. The events precipitating the need for transfusion were low Hb level in 9 patients and hypotension or excessive bleeding in 18 patients. Conclusion: The preoperative Hb level of >11 facilitates OPCAB without transfusion. These results suggest that transfusion-free OPCAB can be performed by modifying the risk factors and correctable causes of transfusion and improving various blood salvage methods.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.167-171
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• 2009

Purpose: It is important to begin a transfusion safely and appropriately as soon as possible in a hemorrhagic shock patient. A group $O^+$ unmatched pack red blood cell (universal $O^+$) transfusion may satisfy that requirement. We report our experiences with universal $O^+$ to compare its usefulness for hemorrhagic shock patients with that of a matched pack red blood cell transfusion in the emergency department (ED). Methods: This is a retrospective study. Patients who had systolic blood pressure of less than 90 mmHg or a pulse rate of more than 120 beats per minute in the ED were included, and their medical records were reviewed. The collected data were demographic data, vital signs, blood test results, time to transfusion, the amount of transfusion, complications, and diagnoses. We calculated the emergency transfusion score (ETS) based on the patients' medical records. Results: Two hundred thirty-five patients were included. Forty-eight patients (36 trauma and 12 non-trauma patients) were transfused with a universal $O^+$. These patients had less time to transfusion compared with the cross-matched transfusion groups (35${\pm}$42 versus $170{\pm}187$ minutes, p<0.001). There were no differences in complications between groups (p=0.076). Of the patients who were transfused with universal $O^+$, 94.4% got more than 3 ETS. Conclusion: The universal $O^+$ transfusion, compared with matched pack red blood cell transfusion, should be a useful treatment for ED hemorrhagic shock patient due to its having a shorter time to transfusion without an increase in complications.

• The Korean Journal of Blood Transfusion
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• v.23 no.2
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• pp.136-144
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• 2012

Background: Fresh frozen plasma (FFP) transfusion is administered primarily for management of acquired bleeding disorders. However, in practice, FFP transfusion is increasing without a solid rationale. Methods: We conducted an audit to evaluate the appropriateness of the indications for FFP transfusion during the period from July 2010 through June 2011. Assessment of the appropriateness of the indications was based on the national transfusion guidelines and the transfusion criteria promulgated by the Severance Hospital. Results: In total, 17,733 units of plasma were transfused to 1,949 patients over 4,982 events. We found that administration of FFP was not in compliance with the recommended guidelines in 1,990 events. The number of total FFP transfusions was higher in medical departments (Gastroenterology) than in surgical departments (Thoracic and cardiovascular surgery, General surgery). However, the proportion of cases of inappropriate transfusion was higher in surgical departments than in medical departments. Both the total number of FFP transfusion and the proportion of inappropriate transfusion were high in patient with neoplasm, disease of the digestive system, and diseases of the circulatory system. Conclusion: Continuous monitoring on appropriateness for FFP transfusion and feedback to the physician are critical in securing the transfusion safety as well as maintaining the quality of FFP transfusion. New-found indication for FFP transfusion should be investigated and applied in timely manner.