THE NECESSITY FOR ALBUMIN PRODUCTS IN ABO-INCOMPATIBLE RENAL TRANSPLANTATION

DOI 6 References
  • Moriya Tomomi
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Okamoto Yoshio
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Kobayashi Hirohito
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Matsuda Kazuki
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Kubota Tomoaki
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Ogata Yasutaka
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Oikawa Miyuki
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Lee Maiko
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Kinoshita Akemi
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Aoki Takako
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Chino Mineko
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Okada Shin-ichi
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Kohgen Yumi
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Aoki Masahiro
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Nakabayashi Kyoko
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Konno Mayumi
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Utsugisawa Taiju
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Ogura Hiromi
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University
  • Kanno Hitoshi
    Department of Transfusion Medicine and Cell Processing, Tokyo Women's Medical University

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Other Title
  • ABO血液型不適合腎移植におけるアルブミン製剤の必要性

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Abstract

The Ministry of Health, Labour and Welfare evaluated the appropriateness of institutional standards for transfusion management systems and the adequate use of blood products in 2012. Our hospital fulfilled standards in a transfusion management system, but did not receive an additional credit for adequate use of blood products due to excess use of albumin as well as fresh frozen plasma in plasma exchange, cardiovascular surgery and organ transplantation. Regarding albumin consumption, total use of albumin products exceeded 180 kg per year, representing over 0.5% of the total use in Japan. In this study, we surveyed albumin consumption in each clinical department, and noted that approximately 12% of albumin was used in plasma exchange accompanying renal transplantation. When compared between ABO-matched and -mismatched renal transplantation, the former consumed 83.5±17.4 g and the latter used 325.6±30.4 g albumin per transplantation. In 2011, the total number of renal transplantations was 185, and about 1/3 were from ABO-mismatched donors. It is absolutely necessary for ABO-mismatched renal transplantation to remove anti-A or B antibody before operation through 2 to 4 rounds of plasma exchange. Over 200,000 patients suffer from chronic renal insufficiency in Japan, and the shortage of donors has become a serious problem. To overcome this, ABO-mismatched renal plantation must be encouraged. Against this background, we propose that a multi-institutional collaborative study is required to survey the amount of albumin used in plasma exchange in renal transplantation. We also propose that the guidelines for appropriate use of albumin for plasma exchange should be reconsidered.

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