Results of the survey on the present state of ABO-incompatible blood transfusion in Japan.

Here we report the results of the National (Fact-finding) Survey on the present state of ABO-incompatible blood transfusions in Japan performed by the Japanese Society of Blood Transfusion. The targets of the survey were 777 hospitals with more than 300 beds, which have transfused more than 3, 000 units of blood products per year. The survey was performed in the style of anonymous questionnaire-based survey.The questionnaire focused on the presence or absence of ABO-mismatched transfusions in the 5-year period, between January 1995 and December 1999. The target blood products included whole blood, red cell concentrates and fresh-frozen plasma (FFP), the platelet concentrates being excluded. Among the 777 hospitals, answer could be obtained from 575, and 20% of them have experienced ABO-mismatched transfusion at least once in the period of the study. The frequency of ABO-mismatched transfusion increased with increasing the number of beds and the units of transfused blood. Approximately 50% of the hospitals with more than 700 beds and/or with more than 40 thousand units of transfused blood per year have experienced it. ABO-incompatible transfusion was performed in 166 cases (115 hospitals), and the blood products used were red cell concentrates in 90 cases, whole blood in 5 and FFP in 71. The main causes of transfusion error were change of blood bags in 71 cases (42.8%), incorrect blood typing in 25 (15.1%), and failure to identify patient in 19 (11.5%). The transfusion errors were caused by nurses in 78 cases (44.6%), doctors in 72 (41.1%), and laboratory technicians in 18 (10.3%). The evolution of the patients transfused ABO-incompatible blood was recorded as deceased in 6, among them 1 died of hemorrhage due to severe trauma. Additional 3 cases have deceased, but the cause could not be defined as either the ABO-incompatible transfusion or the basic disease.