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1

2

3 ABO 15 RhoD T&S 24 MSBOS 24 SBOE

4

5

6

7 GVHDTRALI Yersinia enterocolitica HIV B

8 NAT

9 1 2 3

10

11 MAP 2 3

12 HIV

13

14

15 ABORhoD HBsHBsHBc HCV HIV HTLV HBV HCVHIVNAT ALTGPT B B 1 2 GyGy

16 1 ABOAB AB AB AB 2 3 DRhoD

17 D AB ABORhoD ABORhoD 1 ABORhoD

18 2 1 ABO 2 ABO ABO RhoDABORho D 3 ABO 4 ABORhoD ABO

19 5 ABO OA B 6 O ABO

20 1 ABORhoD ABO 2 ABO O OABO 3 RhoDRhoD RhoDABO RhoD RhoD D D RhoD. 4 O RhoDRhoD

21 1 ABO ABO RhoD 2 ABO 3 O

22 ABO O A O B O AB OAB O 1 ABO 2 AB ABO ABORhoDRhoD

23 3 ABO RhoD RhoD RhoD DD 1 2 1

24 2 3 4

25 T&S MSBOS ABORhoD RhoD ABO TCC/T.

26 HbHbHb g/dl Hb Hb.T&S. 1

27 2 3 Yersinia enterocolitica 4

28 5 6 7 ID 8 PDA 9

29 10 SpO 1 ABO 2 1

30 2 TRALI ml ml

31 1 1 ABO

32 2 Delayed Hemolytic Transfusion Reaction ; DHTR 2 1 TRALI

33 Yersinia enterocolitica TRALI TRALI TRALI

34 volume overload TRALI TRALI HLA 2

35 B HBs HBs HBc NAT C HCV HCV HCV HIV HIV T THTLV

36

37 1 2 3

38 kg kgml Yersinia enterocolitica

39 VVR 1 2 3

40

41

42

43 X

44 1

45

46

47

48

49 .. / /

50

51 1 / Hbg/dL Hbg/dL B Hbg/dL 2 Hbg/dL g/dl Hb

52 3 1 /Hb g/dlht 2 HES,mL ml/ Hbg/dL Hb g/dl 3

53 Hb Hbg/dLHbg/dL ml/kg dlkgml/kg/ kgdlhb g/dlml LRmL Hbg/dL/dL ghb.g/dl

54 /L /L /L /L /L 1 /L 2 /L

55 /L 3 /L /L oozing /L 4 5 DIC /L DIC

56 6 1 /L /L 2 /L /L /L 3 ITP ITP ITP NAIT PTP

57 /L /L 8 /L /L

58 /L ml ml/kg.,mlkg,/l kg

59 PT APTT 1 1/PT INR.APTT PTINR. L DICPTAPTT mg/dl DIC

60 PTINR.K 2100/ DIC L 2 CS 3 TTPTTP

61 TTP HUS ml/kgml/kght/ ml/kgml/kg DIC

62 1.g/dL,mL 2 kg

63 3 L

64 .g/dl 8 9 g g/dldl..dl/kg/ 1 2 3

65

66

67 1,mL

68 2

69 3 HES TTP/HUS

70 4 LL 5

71 Red Cell Concentrate ; RCC 1 B

72 Hb Hbg/dL Hbg/dL Hb / Hbg/dL Hb iron overload

73 Hb g/dl 2 Hb class class class class Hbg/dL g/dl

74 Hbg/dL Hb 3 1 /Hb g/dlht Ht

75 2 HES ml/kg ml/kg

76 ,ml ml/

77 mmhgmmhg.ml/kg/ Hbg/dL Hbg/dL 3 Hb Hbg/dLHbg/dL ml/kg dlkgml/kg/ kg dlhb

78 g/dlmllr mlhb g/dl/dlg Hb.g/dL 1 2 1

79 Yersinia enterocolitica 2 mlmg mg Hbg mg Hb 3 Gy ml meq

80 4 5 ABO ID American College of Surgeons : Advanced Trauma Life Support Course Manual. American College of Surgeons. ; American Society of Anesthesiologists Task Force : Practice guideline for blood component therapy. Anesthesiology. ; : LundsgaardHansen P, et al : Component therapy of surgical hemorrhage : Red cell concentrates, colloids and crystalloids. Bibl. Haematol. ; : GVHD GVHD

81 Platelet Concentrate ; PC 13 /L /L /L

82 /L /L f. /L /L /L /L /L

83 /L /L /L oozing /L/L

84 DIC /L DIC DIC DIC DIC 1 /L /L /L HLA DIC /L

85 2 /L /L /L 3 Idiopathic Thrombocytopenic Purpura ; ITP ITP ITP Neonatal Alloimmune Thrombocytopenia ; NAIT

86 Posttransfusion Purpura ; PTP 4 TTPHUS 5 6 /L

87 /L /L /L / L DIC HLA

88 HLAHLA HLA HLA HLA HLA HLA HLA /L /L ml / ml/kg

89 .,mlkg,/l kg corrected count increment ; CCICCI CCI/L / CCI,/L CCI,/L

90 PTGVHD Gy 5 CMV

91 CMV CMV CMV CMV 6 7 ABO RhRh Rh RhRHIG D HLA HLA ABO 8 ABOABO AB

92 AB ABO British Committee for Standards in Haematology, Blood Transfusion Task Force : Guidelines for the use of platelet transfusions. Br. J. Haematol. ; : Schiffer CA, et al : Clinical Practice Guidelines of the American Society of Clinical Oncology. J. Clin. Oncol. ; : A Report by the American Society of Anesthesiologists Task Force on Blood Component Therapy : Practice Guidelines for Blood Component Therapy. Anesthesiology. ; : Wandt H, et al : Safety and cost effectiveness of a / L trigger for prophylactic platelet transfusions compared with the traditional / L trigger : a prospective comparative trial in patients with acute myeloid leukemia. Blood. ; : Rebulla P, et al : The threshold for prophylactic platelet transfusions in adults with acute myeloid leukemia. Gruppo Italiano Malattie Ematologiche Mallgne dell'adulto. N. Engl. J. Med. ; : Heckman KD, et al : Randomized study of prophylactic platelet transfusion threshold during Induction therapy for adult acute leukemia :, / microl versus, / microl. J. Clin. Oncol. ; :

93 Fresh Frozen Plasma ; FFP PTAPTT DIC

94 1 1 PTINR.APTT PTAPTT./ PTINR. L

95 L DICDIC CS PTAPTT mg/dl DIC mg/dl PTAPTT

96 A B PTINR. K K

97 2100/ PTAPTT DICDIC LL 2 CS CS C C 3 TTP unusually large ULvWFM ULvWFM

98 vwf ADAMTS TTP./ ULvWFMvWF TTP OH HUS ml/kgml/kght/ ml/kgml/kg kgml LR.mLFFPLRmL mlffplrml ml FFPLR mlffplr

99 ml Ht

100

101 5 DIC LR

102 CPD.mLFFPLR mlmlffplrml ml.gmeqml FFPLR.gmEq Na ACDAmL.gmEqNa CPDACDA 5 6

103 PTAPTT /LPTINR. APTT mg/dl DDAVP Atype

104 VWFADAMTS TTP/HUS Mori Y, et al : Predicting response to plasma exchange in patients with thrombotic thrombocytopenic purpura with measurement of vwfcleaving protease activity. Transfusion. ; : AABB : Blood Transfusion Therapy ; A Physicians Handbook th ed.,, p.

105 1. g/dl,ml

106 2 Alb kg 3 L Runyon BA : Management of adult patients with ascites due to cirrhosis. Hepatology ; : 4

107 5 6

108 . 7.g/dL 8 9

109 g g/dldl..dl/kg/ kg.g/dl.g/dl.dl/kgkg...g g/dlkg g kgg /g/dl g./.dl/kgkg/g/dl.g/dl. g/dl

110 g/dL 4

111 1.mg/mLmEq/L 2 ml gml 3 ml/ 4 5 g/dl ph TP

112 Cg/dL.C.C.C Cg/dL.C.C.C Alb.g/dL......mmHg TP.g/dL......mmHg 1

113 1 1 Hbg/dL Hbg/dL MAPMAP RCC 2 ml/kgml/kg/

114 ml/kg/ 3 1 MAP MAP G MAP LR LR 2 3

115 Gy 1 /L /L /L /L 1 1 KPT APTT 2/ 3

116 2 ml/kg ml/kg 3

117 1 Hb Hb g/dl RCC Hb RCC cytomegalovirus ; CMV CMV CMV CMV MAP LRLR

118 2 PC /L /L HLA

119 matchmajor mismatchminor mismatchmajor and minor mismatch

120 ABO ABOAB O RhoDRho DRhoD RhoD RhoDRhoD

121 ABORhoD

122 SBOE HbHbg/dL Hb ml ml/kgml.g/dl HbHt HbHt

123 offpump Hb Hbg/dLg/dL sequestration A

124 /L TEG

125 Hb.g/dL Hb HbHb g/dl g/dl

126 INR mosm/l

127 mosm/l Ht //

128 .ml/ kg/min MAP ABOABO

129 ABO 10 g/dl 11 Ht DPG MAPDPG

130 DPG 12 Ht Ht Ht critical oxygen deliverydo crit DO crit ml/min,mlht HtHt Ht Ht

131 Hbg/dLHt HtHb..g/dL Hb..g/dL ASA Hbg/dL 13

132 14 PTINR. TTP HUSTTP von Willebrand Factor von Willebrand Factor Cleaving ProteasevWFCPADAMTS

133 vwfcp vwfcp vwfcp BCSH.Guideline Guidelines on the Diagnosis and Management of the Thrombotic Microangiopathic Haemolytic Anemias. British Journal of Haematology ; : 15 CPD citratephosphatedextrose.g/l.g/l.g/l.g/l ACDAacidcitrate dextrose.g/l.g/l.g/l CPD MAPmannitol adeninephosphated.g/l.g/l.g/l.g/l.g/l.g/l.g/l MAPMAPRCC MAP MAPMAP MAPLR

134 LR LRCPD mlmlmlml MAPmL mlcpd LR LRLR ml RCCLR ml mlrcclrml mlht Hbg/dL LRLR LRLR MAPMA P

135

136

137 16. HLA

138

139 17 LR CPDmLmL mlml mlffplr mlffplr ACDA ml FFP LR ml

140 Quarantine NAT

141

142 18 1.w/v HBVHCV HIV AHAVE HEV 2, g ml g.g/kg.g/kg/

143 Vamvakas EC : Is white blood cell reductionequivalent to a n t i body screening i n p r eve n t i n g t r a nsmission of Cytomegalovirus by transfusion? A review of the literature and metaanalysis. Transfus. Med. Rev. ; : Stover EP, et al : Variability in transfusion practice for coronary artery bypass surgery persists despite national consensus guidelines. Anesthesiology. ; : Hessel EA, et al : Platelet kinetics during deep hypothermia. J. Surg. Res. ; : Valeri CR, et al : Hypothermiainduced reversible platelet dysfunction. Ann. Surg. ; : Michelson AD, et al : Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro. Thromb. haemost. ; : Boldt J, et al : Normothermic versus hypothermic cardiopulmonary bypass : do changes in coagulation differ? Ann. Thorac. Surg. ; : Nuttall GA, et al : Efficacy of a simple intraoperative transfusion algorithm for nonerythrocyte component utilization after cardiopulmonary bypass. Anesthesiology. ; : Karski JM, et al : Etiology of preoperative anemia in patients undergoing scheduled cardiac surgery. Can. J. Anaesth. ; : Williams GD, et al : Factors associated with blood loss and blood product transfusions : A multivariate analysis in children

144 after openheart surgery. Anesth. Analg. ; : ShoreLesserson, et al : Thromboelastographyguided transfusion algorithm reduces transfusions in complex cardiac surgery. Anesth. Analg. ; : Dougenis D, et al : Blood use in lung resection for carcinoma : perioperative elective anaemia does not compromise the early outcome. Eur. J. Cardiothorac. Surg. ; : Motoyama S, et al : Use of autologous instead of allogeneic blood transfusion during esophagectomy prolongs diseasefree survival among patients with recurrent esophageal cancer. J. Surg. Oncol. ; : Kinoshita Y, et al : Usefulness of autologous blood transfusion for avoiding allogenic transfusion and infectious complications after esophageal cancer resection. Surgery. ; : Takemura M, et al : Immunologic effects of allogeneic versus autologous blood transfusion in patients undergoing radical oesophagectomy. Eur. Surg. Res. ; : Dresner SM, et al : Prognostic significance of perioperative blood transfusion following radical resection for oesophageal carcinoma. Eur. J. Surg. Oncol. ; : Schmied H, et al : The effects of redcell scavenging, hemodilution, and active warming on allogenic blood requirements in patients undergoing hip or knee arthroplasty. Anesth. Analg. ; : McSwiney MM, et al : Blood transfusion in total hip arthroplasty : guidelines to eliminate overtransfusion. Can. J. Anaesth. ; : : Olfsger D, et al : Acute normovolemic haemodilution decreases postoperative allogenic blood transfusion after total knee replacement. Br. J. Anaesth. ; : : Thomas D, et al : Autologous blood transfusion in total knee

145 replacement surgery. Br. J. Anaesth. ; : Neilipovitz DT, et al : A Randomized trial of tranexamic acid to reduce blood transfusion for scoliosis surgery. Anesth. Analg. ; : Shmied H, et al : Mild hypothermia increases blood loss and transfusion requirements during total hip arhtroplasty. Lancet. ; : Monk TG, et al : Acute normovolemic hemodilution can replace preoperative autologous blood donation as a standard of care for autologous blood procurement in radical prostatectomy. Anesth. Analg. ; : Bryson GL, et al : Does acute normovolemic hemodilution reduce perioperative allogeneic transfusion? A metaanalysis. Anesth. Analg. ; : Hogue CW Jr, et al : Perioperative myocardial ischemic episodes are related to hematocrit level in patients undergoing radical prostatectomy. Transfusion. ; : Linko K, et al : Electrolyte and acidbase disturbances caused by blood transfusion. Acta. Anaesthesiol. Scand. ; : Brown KA, et al : Hyperkalemia during rapid blood transfusion and hypovolaemic cardiac arrest in children. Can. J. Anaesth. ; : Jameson LC, et al : Hyperkalemic death during use of a high capacity fluid warmer for massive transfusion. Anesthesiology. ; : Rock G, et al : Effect of citrate anticoagulations on factor levels in plasma. Transfusion. ; : Murray DJ, et al : Coagulation changes during packed red cell replacement of major blood loss. Anesthesiology. ; Consensus Conference : Fresh frozen plasma. Indications and

146 risks. JAMA. ; : Harke H, et al : Haemostatic disorders in massive transfusion. Bibl. Haematol. ; : Ferrara A, et al : Hypothermia and acidosis worsen coagulopathy in the patient requiring multiple transfusion. Am. J. Surg. ; : SunderPlessman L, et al : Acute normovolemic hemodilution : change in tissue oxygen supply and hemoglobinoxygen affinity. Bibl. Haematol. ; : Shah DM, et al : Failure of red blood cell transfusion to increase oxygen transport or mixed venous PO in injured patients. J. Trauma. ; : Rosberg B, et al : Hemodynamics following normovolemic hemodilution in elderly patients. Acta. Anaesthesiol. Scand. ; : VaraThorbeck R, et al : Hemodynamic response of elderly patients undergoing major surgery under moderate normovolemic hemodilution. Eur. Surg. Res. ; : Messmer K : Hemodilution. Surg. Clin. North. Am. ; : Shibutani K, et al : Critical levels of oxygen delivery in anesthetized man. Crit. Care. Med. ; : Carson JL, et al : Severity of anaemia and operative mortality and morbidity. Lancet. ; : Hogue CW Jr, et al : Perioperative myocardial ischemic episodes are related to hematocrit level inpatients undergoing radical prostatectomy. Transfusion. ; :. Rao SV, et al : Relationship of blood transfusion and clinical outcome in patients with acute coronary syndromes. JAMA. ; : Wu WC, et al : Blood transfusion in elderly patients with acute

147 myocardial infarction. N. Engl. J. Med. ; : Stehling L, et al : The red blood cell transfusion trigger. Arch. Pathol. lab. Med. ; : Spence RK : Emerging trends in surgical blood transfusion. Semin. Hematol. ; : Task force on blood component therapy : Practice guidelines for blood component therapy. A report by the American Society of Anesthesiologists task force on blood component therapy. Anesthesiology. ; : College of American Pathologists : Practice parameter for the use of freshfrozen plasma, cryoprecipitate, and platelets. JAMA. ; : Simon A, et al : Practice parameter for the use of red blood cell transfusions. Arch. Pathol. Lab. Med. ; : American Society of Anesthesiologists Task Force on Blood Component Therapy : Practice guidelines for blood component therapy : A report by the American Society of Anesthesiologists Task Force on blood component therapy. Anesthesiology. ; : Nuttall GA, et al : Current transfusion practices of members of the American Society of Anesthesiologists : A survery. Anesthesiology. ; : MAP MAP Survival study

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150 15 50

151

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153 17

154 17

155 19 26

156 mlml mlml mlml 19 26

157

158 21 20

159 . ml ml 21 20

160 GVHD 21 20

161 MEMO

162

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untitled 1) American College of Surgeons:Advanced Trauma Life Support Course Manual. American College of Surgeons 1997;103-112 24 2) American Society of Anesthesiologists Task Force:Practice guideline for blood

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参考 18 アルブミンの製法と性状 1) 製法 製剤アルブミン製剤は, 多人数分の血漿をプールして, 冷エタノール法により分画された蛋白成分である 含有蛋白質の 96% 以上がアルブミンである製剤を人血清アルブミンといい, 等張 ( 正常血漿と膠質浸透圧が等しい ) の 5% 溶液と高張の 20,2

参考 18 アルブミンの製法と性状 1) 製法 製剤アルブミン製剤は, 多人数分の血漿をプールして, 冷エタノール法により分画された蛋白成分である 含有蛋白質の 96% 以上がアルブミンである製剤を人血清アルブミンといい, 等張 ( 正常血漿と膠質浸透圧が等しい ) の 5% 溶液と高張の 20,2 68 参考 18 アルブミンの製法と性状 1) 製法 製剤アルブミン製剤は, 多人数分の血漿をプールして, 冷エタノール法により分画された蛋白成分である 含有蛋白質の 96% 以上がアルブミンである製剤を人血清アルブミンといい, 等張 ( 正常血漿と膠質浸透圧が等しい ) の 5% 溶液と高張の 20,25% 溶液とがある また, 等張製剤にはアルブミン濃度が 4.4w/v% 以上で含有総蛋白質の

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<4D F736F F D D81758C8C897490BB8DDC82CC8E E77906A FC92E894C5816A2E646F63>

<4D F736F F D D81758C8C897490BB8DDC82CC8E E77906A FC92E894C5816A2E646F63> 新鮮凍結血漿の組成は, 採血時に混合した血液保存液 ( 全血液由来は ACD-A 液又は CPD 液, 成分採血由来は ACD-A 液を使用 ) により異なる ( 表 4) 含有成分は血液保存液により希釈されて, 単位容積当たりの濃度は正常血漿と比較して, およそ 10 15% 低下している 例えば, アルブミン濃度は約 4.0g/dL( 全量約 3g/ 単位 ) と低くなっている また, 血漿中の凝固因子活性の個人差は大きいが,

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参考 16 血小板濃厚液の製法と性状血小板濃厚液の調製法には, 採血した全血を常温に保存し製剤化する方法と, 単一供血者から成分採血装置を使用して調製する方法があるが, 日本赤十字社から供給される血小板濃厚液では, 全血採血由来の保存前白血球除去の導入により, 白血球とともに血小板も除去されることか

参考 16 血小板濃厚液の製法と性状血小板濃厚液の調製法には, 採血した全血を常温に保存し製剤化する方法と, 単一供血者から成分採血装置を使用して調製する方法があるが, 日本赤十字社から供給される血小板濃厚液では, 全血採血由来の保存前白血球除去の導入により, 白血球とともに血小板も除去されることか 参考 16 血小板濃厚液の製法と性状血小板濃厚液の調製法には, 採血した全血を常温に保存し製剤化する方法と, 単一供血者から成分採血装置を使用して調製する方法があるが, 日本赤十字社から供給される血小板濃厚液では, 全血採血由来の保存前白血球除去の導入により, 白血球とともに血小板も除去されることから ( 製造工程において使用する白血球除去フィルターに吸着される ), 現在は, 全血採血からは製造しておらず,

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