국내 백혈구여과제거 혈액제제의 사용현황
The Status of Use of Leukoreduced Blood Products in Korean Hospitals
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배경: 백혈구제거 혈액제제는 비용혈 발열성수혈반응, HLA 동종면역, 혈소판 수혈불응, 수혈전파성감염 등의 부작용을 예방하기 위하여 사용되고 있다. 특히, 저장 전 여과법은 저장 후 여과법에 비하여 각종 수혈부작용을 예방하는데 더 효과적이다. 본 연구에서는국내 백혈구여과제거 혈액제제의 사용현황에 대하여 조사하였다. 방법: 2009년 1월 1일부터 12월 31일까지 1년간 대한적십자사 혈액원 또는 대한산업보건협회부설 한마음혈액원으로부터 수혈용 혈액제제를 공급받은 전국 의료기관 2,373개 기관을 대상으로 설문조사를 시행하였다. 설문조사는 개발된 웹 기반의 프로그램(http://bms.cdc.go.kr)을 통하여 이루어졌으며, 설문조사에 응답한 743개의 의료기관의 자료로 연구를 수행하였다. 결과: 743개 설문 회신 의료기관에서 1년간 사용된 1,593,098단위의 적혈구제제 중에서 prestorage LR-RBC는 91,066단위(5.7%),poststorage LR-RBC는 73,192단위(4.6%)로 백혈구여과제거 적혈구제제의 총 비율은 10.3%이었다. 397개 혈소판제제 사용 의료기관에서 1년간 사용된 1,386,184단위의 농축혈소판제제 중 458,552단위(33.1%)가 백혈구여과제거 농축혈소판제제로 사용되었다. 1단위의 성분채혈혈소판제제를 6단위의 농축혈소판제제로 환산할 경우 전체 혈소판제제 사용량의 48.9%가 백혈구여과제거가 시행되었다. 결론: 국내의 백혈구여과제거 농축적혈구의 점유율이 미국에 비하여 많이 낮으며, 특히, 저장전 백혈구여과제거 농축적혈구제제의 제조도 적게 이루어지는 것으로 나타났다. 향후 국내 실정에 맞는 백혈구여과제거 혈액제제의 효용성 및 비용-효과적인 면에 대한 연구들이 필요하며, 이들을 바탕으로 국내 실정에 맞는 저장전백혈구여과제거술이 시행되어야 할 것으로 사료된다.
Abstract
Background: Leukoreduced blood components are recommended for prevention of non-hemolytic febrile transfusion reactions, HLA alloimmunization, platelet transfusion refractoriness, and transfusion-transmissible diseases. In addition, prestorage leukoreduction may be advantageous to poststorage leukoreduction. The authors investigated the current status of usage of leukoreduced blood components in Korea. Methods: We surveyed 2,373 medical facilities, where blood components were supplied from Korean Red Cross blood centers and/or Hanmaeum blood center during one year period between January and December 2009. The survey was conducted about the current situation of usage of leukoreduction by web-based program (http://bms.cdc.go.kr), and 743 facilities answered and were analyzed. Results: The leukoreduced RBC components comprised 10.3% (prestorage leukoreduction, 91,066 units, 5.7%; poststorage leukoreduction 73,192 units, 4.6%) of the total 1,593,098 units of RBC components used in 743 medical facilities. The leukoreduced platelet concentrates comprised 33.1% (458,552 units) of the total 1,386,184 units of platelet concentrates used in 397 medical facilities. If 1 single donor platelet is counted as 6 platelet concentrates, 48.9% of the total platelet components used were leukoreduced. Conclusions: The proportion of leukoreduced blood components to the total blood components used in Korea was much lower than that in Unites States of America, especially lower in the use of prestorage leukoreduction of RBC components. Further studies are required for cost-effectiveness and demand-supply amounts of leukoreduced blood components, and appropriate prestorage leukoreduction has to be performed in Korea based on these studies.
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