NoBlood

Jan B. Wade · #1 (**permalink**) 12-26-2004, 06:08 PM

Survey finds hospitals neglectful

Yomiuri Shimbun

Only 12 percent of hospitals conduct posttransfusion blood tests on all recipients as required by a government guideline, the Health, Labor and Welfare Ministry said Saturday in its first nationwide survey on the issue.

Under the government guideline, hospitals should test all such patients for side effects or infections.

Even though many more cases of infection through blood transfusions, including the transmission of viral hepatitis, have surfaced recently, the survey indicates a large number of infections may have gone undetected.

According to the survey, many hospitals have not complied with the government guideline as more than half surveyed did not put doctors in charge of blood transfusions.

The ministry plans to instruct local governments to help hospitals improve internal systems dealing with blood transfusions.

Early this year, questionnaires were sent to hospitals, asking for information on blood transfusions conducted in fiscal 2002.

The ministry received replies from 2,572 hospitals that had conducted the procedure.

Even among large hospitals, which have 500 or more beds and perform blood transfusions regularly, only 15 percent said they had tested recipients.

Twenty-six percent said they never conducted such checks.

The government guideline requires patients to be tested three months after a transfusion at the minimum. But 32 percent of the hospitals surveyed and 26 percent of large hospitals said they rarely did so.

Ministry officials said if hepatitis infections, which can easily occur through blood transfusions, happened at hospitals, patients might remain unaware of the infection for a long time, fail to receive treatment until symptoms develop.

In such cases, it is highly likely that the infection will not be reported to the Japanese Red Cross Society or the central government, the officials added.

Doctors are placed in charge of blood transfusions, as required under the government guideline, at only 44 percent of hospitals.

The survey found that the smaller a hospital was, the less compliant its system was with the law. Among hospitals with fewer than 200 beds, 70 percent did not put doctors in charge of blood transfusions.

Millions of transfusions, including those that use blood products, are conducted across the nation annually.

The Japanese Red Cross Society has implemented high-level safety measures that meet worldwide standards on donated blood from which blood products are made.

For example, the society checks samples of donated blood for genetic diseases or other problems.

But the checks sometimes fail to detect abnormalities when donated blood contains very few bacteria.

As a result, about 120 cases of infections with hepatitis, among other diseases, are believed to be caused by blood transfusions each year.

In addition to hepatitis B, which can be deadly, and hepatitis C, which can develop into liver cirrhosis or liver cancer, the AIDS virus also can be passed through blood transfusions, with one case detected in late 2003.

Masayoshi Takano, senior director of the Blood Products Research Organization who led the ministry team that conducted the survey, said, "Some patients do not bother about checks after they are discharged from hospital, but I can't say all hospitals are proactive in conducting the tests."

"Hospitals aren't sufficiently aware of the risks posed by blood transfusions," he said.

The guideline concerning the procedure was implemented by the ministry's predecessor--the Health and Welfare Ministry--in 1999. Under the guideline, hospitals are required to conduct safety measures against side effects and the risk of infections from blood transfusions as an essential approach in modern medicine.

NoBlood

Japanese - Survey finds hospitals neglectful