自己末梢血幹細胞採取におけるアフェレシスの安全管理 : 医療施設で採取する場合(<特集>ドナーアフェレシスの安全性)
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概要
- 論文の詳細を見る
The most effective and important point to maintain the safe management of ABSCT (autologous peripheral blood stem-cell transplantation)is to build a blood transfusion service, which has enough stuff who skill apheresis procedure in each hospital. Without university hospitals, few hospitals, unfortunately, have transfusion services as a result of financial reasons because too many hospitals perform such high-level treatment. Patients who need ABSCT have a high risk of infection or bleeding by myelo-suppression because of recent chemotherapy. Furthermore, these patients have systemic complications as a result of drug intoxication in such area as the heart, lung and kidney. Therefore, an informed consent for apheresis is essential. We recommend making technical manuals in each step such as a planning report, a patient's estimation records, and an apheresis record. A vasovagal reflex and citrate intoxication are main complications during apheresis. ECG and pulse oximeter are useful tools for monitoring vital signs during apheresis because a pressure cuff for blood pressure measurement is not available. If hypovolemia is to be prevented, blood priming is necessary for children harvest whose body weights are less than 20kg. The administration of potassium during harvest by IV injection is not recommended, even though a patient has severe hypokalemia, because it causes cardiac arrhythmia. An accumulation of incident reports is also useful for safe management.
- 日本アフェレシス学会の論文
- 2002-10-31