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Storage-related changes in and the effect of autologous and allogeneic blood transfusion in patients undergoing cardiac surgery with cardiopulmonary bypass

Research Project

Project/Area Number 17K11096
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Anesthesiology
Research InstitutionTokyo Women's Medical University

Principal Investigator

Ichikawa Junko  東京女子医科大学, 医学部, 講師 (60318144)

Co-Investigator(Kenkyū-buntansha) 小森 万希子  東京女子医科大学, 医学部, 教授 (60178332)
小高 光晴  東京女子医科大学, 医学部, 臨床教授 (90280635)
Project Period (FY) 2017-04-01 – 2021-03-31
Project Status Completed (Fiscal Year 2020)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords赤血球変形能 / 自己血 / 他科血 / 貯蔵期間中の変化 / 赤血球膜骨格 / 膜変形能 / 濃厚赤血球製剤 / 体外循環 / 自己血製剤 / 保存血液 / 輸血 / 輸血貯蔵期間中の変化 / 赤血球変形能低下
Outline of Final Research Achievements

During storage, time-dependent biochemical changes and significant decreases in deformability occurred in homologous RBCs in compared with autologous RBCs. Morphological changes at initiation of CPB are considered potentially reversible transformations without loss of the membrane surface area, and do not have a significant effect on deformability. A decrease in deformability is likely due to transfusion of stored RBCs. In the homologous transfusion group, RBC deformability, MCV, and MCHC significantly and dose-dependently changed during surgery, and a greater number of denser subpopulations was observed at surgery completion. In contrast, these changes were not observed in patients receiving autologous transfusion. Blood processing techniques rather than storage duration contribute to storage lesions, suggesting that transfusion of autologous WB compared to allogenic RBCs, could maintain the ability of circulating RBCs to deform and lead to potentially better clinical outcomes.

Academic Significance and Societal Importance of the Research Achievements

本研究により貯蔵期間中の赤血球膜骨格の機能的、形態学的な変化は、保存期間よりも保存液の種類や放射線照射などに大きな影響を受け、こうした変化は老化赤血球の機能、形態に準じた。患者血への影響は、投与した貯蔵血が出血によって失われた血液に置換されることにより生じ、他科血の場合には投与量に比例して患者血が変化する。全血で保存された自己血は放射線照射されず、平均貯蔵期間が他科血に比して長いにも関わらず膜骨格の変化が小さく、投与後に患者血に及ぼす影響も小さく、酸素運搬能が保持され安全性が高いことが推測された。赤血球膜骨格の形態・機能の研究は、寿命のメカニズムの一部を明らかにし、安全な輸血管理に資する。

Report

(5 results)
  • 2020 Annual Research Report   Final Research Report ( PDF )
  • 2019 Research-status Report
  • 2018 Research-status Report
  • 2017 Research-status Report
  • Research Products

    (32 results)

All 2021 2020 2019 2018 2017 2016

All Journal Article (12 results) (of which Peer Reviewed: 10 results,  Open Access: 6 results) Presentation (16 results) (of which Int'l Joint Research: 2 results,  Invited: 3 results) Book (4 results)

  • [Journal Article] Postmortem Computed Tomography Scan as Autopsy Imaging at a Single Tertiary Center:1-Year Review2020

    • Author(s)
      市川 順子, 甲田 正紀, 西山 圭子, 小高 光晴, 有山 淳, 小森 万希子
    • Journal Title

      THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA

      Volume: 40 Issue: 7 Pages: 588-591

    • DOI

      10.2199/jjsca.40.588

    • NAID

      130007959713

    • ISSN
      0285-4945, 1349-9149
    • Year and Date
      2020-11-15
    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Dose-dependent effect of stored-blood transfusions on recipient red blood cell indices, deformability and density.2019

    • Author(s)
      Ichikawa J, Koshino I, Komori M
    • Journal Title

      Vox Sang.

      Volume: 114 Issue: 2 Pages: 174-177

    • DOI

      10.1111/vox.12742

    • Related Report
      2019 Research-status Report 2018 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Changes in Erythrocyte Morphology at Initiation of Cardiopulmonary Bypass Without Blood Transfusion Were Not Associated With Less Deformability During Cardiac Surgery.2019

    • Author(s)
      Ichikawa J, Koshino I, Arashiki N, Nakamura F, Komori M.
    • Journal Title

      J Cardiothorac Vasc Anesth.

      Volume: 33 Issue: 11 Pages: 2960-2967

    • DOI

      10.1053/j.jvca.2019.03.030

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] 当院における宗教上の理由による輸血拒否患者に対する手術対応と輸血方針2019

    • Author(s)
      市川順子、笠原彩、西山圭子、小高光晴、小森万希子
    • Journal Title

      日本臨床麻酔学会誌

      Volume: 39 Pages: 381-386

    • NAID

      130007686804

    • Related Report
      2019 Research-status Report 2018 Research-status Report
  • [Journal Article] 過去3年間の麻酔関連アクシデントが関与したヒューマンエラーの要因分析2019

    • Author(s)
      市川順子、向山瑤子、西山圭子、小高光晴、小森万希子
    • Journal Title

      麻酔

      Volume: 68 Pages: 1011-1016

    • NAID

      40022013679

    • Related Report
      2019 Research-status Report
  • [Journal Article] Changes in erythrocyte morphology at initiation of cardiopulmonary bypass without blood transfusion are not associated with less deformability during cardiac surgery2019

    • Author(s)
      Junko Ichikawa, Ichiro Koshino, Nobuto Arashiki, Fumio Nakamura, Makiko Komori
    • Journal Title

      J Cardiothorac Vasc Anesth

      Volume: 印刷中 Issue: 7 Pages: 2103-2103

    • DOI

      10.1053/j.jvca.2019.03.006

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Journal Article] Association Between Platelet Count and Postoperative Blood Loss in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass and Fresh Frozen Plasma Administration Guided by Thromboelastometry2018

    • Author(s)
      Ichikawa J, Osada Y, Kodaka M, Nishiyama K, Komori M.
    • Journal Title

      Circulation Journal

      Volume: 82 Issue: 3 Pages: 677-683

    • DOI

      10.1253/circj.CJ-17-0712

    • NAID

      130006394568

    • ISSN
      1346-9843, 1347-4820
    • Related Report
      2018 Research-status Report 2017 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] 当院の過去1ヶ月の緊急手術時の麻酔説明に関する調査2018

    • Author(s)
      市川順子、二瓶春菜、西山圭子、小高光晴、小森万希子
    • Journal Title

      日本臨床麻酔学会誌

      Volume: 38 Pages: 421-425

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Journal Article] Introduction of thromboelastometry-guided administration of fresh-frozen plasma is associated with decreased allogeneic blood transfusions and post-operative blood loss in cardiopulmonary-bypass surgery.2017

    • Author(s)
      Ichikawa J, Marubuchi T, Nishiyama K, Kodaka M, Ozaki M, Komori M.
    • Journal Title

      Blood Transfus.

      Volume: 23 Pages: 1-9

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] Changes in heparin dose response slope during cardiac surgery: possible result in inaccuracy in predicting heparin bolus dose requirement to achieve target ACT2017

    • Author(s)
      Ichikawa J, Mori T, Kodaka M, Nishiyama K, Ozaki M, Komori M.
    • Journal Title

      Perfusion

      Volume: 32 Issue: 6 Pages: 474-480

    • DOI

      10.1177/0267659117692661

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] 過去3年間のおける麻酔関連のインシデント・アクシデントのSHELL分析に基づく解析2017

    • Author(s)
      市川順子,西山圭子,小高光晴,小森万希子
    • Journal Title

      日臨麻会誌

      Volume: 37 Pages: 1-5

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] Influence of Heparin on the Fibrinogen Level Measured by the Prothrombin Time-Derived Method During Cardiac Surgery With Cardiopulmonary Bypass.2016

    • Author(s)
      Ichikawa J, Kodaka M, Nishiyama K, Komori M.
    • Journal Title

      J Cardiothorac Vasc Anesth.

      Volume: 16 Issue: 3 Pages: 30751-30751

    • DOI

      10.1053/j.jvca.2016.12.025

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 輸液と凝固2021

    • Author(s)
      市川順子
    • Organizer
      体液代謝管理研究会
    • Related Report
      2020 Annual Research Report
  • [Presentation] Changes in platelet aggregation in stored whole blood during acute nonmonomeric hemodilution.2020

    • Author(s)
      Junko Ichikawa
    • Organizer
      米国麻酔学会
    • Related Report
      2020 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 希釈式自己血輸血の貯蔵法が血小板機能に与える影響2020

    • Author(s)
      市川順子
    • Organizer
      日本麻酔学会
    • Related Report
      2020 Annual Research Report
  • [Presentation] Observation of coagulation and fibrinolytic parameters with the use of tranexamic acid during cardiac surgery2019

    • Author(s)
      Junko Ichikawa, Ichiro Koshino, Kazuyoshi Ando, Mitsuharu Kodaka, Makiko Komori
    • Organizer
      American Society of Anesthesiologists' (ASA) annual meeting.
    • Related Report
      2019 Research-status Report
  • [Presentation] 直接経口トロンビン阻害薬(DOAC)内服患者の緊急手術における周術期管理2019

    • Author(s)
      市川順子
    • Organizer
      心臓血管麻酔学会
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] 当施設での心臓手術研究の軌跡と出血低減のためのいくつかの方策2019

    • Author(s)
      市川順子
    • Organizer
      関東甲信越・東京支部合同学術集会
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] スワンガンツカテーテルが左上大静脈に迷入した1症例2019

    • Author(s)
      市川順子、世戸克尚、鈴木孝浩、小森万希子
    • Organizer
      心臓血管麻酔学会
    • Related Report
      2019 Research-status Report
  • [Presentation] Heparin-Protamine-Mangement with ACT, Hepcon HMS and INTEM/HEPTEM CT-ratio2018

    • Author(s)
      Junko Ichikawa
    • Organizer
      Asia Pacific Patient Blood Management Meeting
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] 心臓手術中に濃厚赤血球製剤投与による赤血球の変化は、貯蔵血中の変化に関連する。2018

    • Author(s)
      市川順子、 丸渕貴仁、西山圭子、小高 光晴 、小森 万希子1
    • Organizer
      日本麻酔学会
    • Related Report
      2018 Research-status Report
  • [Presentation] 人工心肺を用いた心臓手術においてトラネキサム酸投与による線溶系変化2018

    • Author(s)
      市川 順子,小高 光晴 ,小森 万希子
    • Organizer
      日本血栓止血学会
    • Related Report
      2018 Research-status Report
  • [Presentation] Storage-related changes in administered blood rather than cardiopulmonary bypass affects the reduced deformability of red blood cells in patients undergoing cardiac surgery2018

    • Author(s)
      Junko Ichikawa, Ichiro Koshino, Yoshiko Osada, Mitsuharu Kodaka, Makiko Komori
    • Organizer
      American Society of Anesthesiologists annual meeting
    • Related Report
      2018 Research-status Report
    • Int'l Joint Research
  • [Presentation] Influence of heparin on the fibrinogen level measured by the prothrombin time-derived method2017

    • Author(s)
      Junko Ichikawa, Keiko Okamura, Goro Kaneko, Keiko Nishiyama, Makiko Komori
    • Organizer
      The European Anesthesiology Congress
    • Related Report
      2017 Research-status Report
  • [Presentation] 心臓手術中に濃厚赤血球製剤投与による赤血球の形態と変形能の変化、およびその関連性2017

    • Author(s)
      市川 順子、越野 一郎、伊藤 実紀子、小森 万希子
    • Organizer
      日本麻酔学会
    • Related Report
      2017 Research-status Report
  • [Presentation] 人工心肺使用の開心術における周術期の凝固・線溶機能が術後出血量に及ぼす影響2017

    • Author(s)
      市川順子、小高光晴、小森万希子
    • Organizer
      日本血栓止血学会
    • Related Report
      2017 Research-status Report
  • [Presentation] 体外循環中に濃厚赤血球製剤の投与は赤血球の変形能を低下させるが、術後1週間で回復する2017

    • Author(s)
      市川順子、森哲、小高光晴、小森万希子
    • Organizer
      心臓血管麻酔学会
    • Related Report
      2017 Research-status Report
  • [Presentation] The association of platelet count with postoperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass and fresh frozen plasma administration guided by thromboelastometry2017

    • Author(s)
      Junko Ichikawa, Ichiro Koshino, Kazuyoshi Ando, Mitsuharu Kodaka, Makiko Komori
    • Organizer
      american society of anesthesiologists annual meeting
    • Related Report
      2017 Research-status Report
  • [Book] LISA2020

    • Author(s)
      市川順子
    • Total Pages
      212
    • Publisher
      メディカル・サイエンス・インターナショナル
    • Related Report
      2020 Annual Research Report
  • [Book] オペナーシング2020

    • Author(s)
      市川順子
    • Total Pages
      220
    • Publisher
      メディカ出版
    • ISBN
      9784840469722
    • Related Report
      2020 Annual Research Report
  • [Book] ICU治療指針Ⅲ2019

    • Author(s)
      市川順子(岡元和文監修)
    • Total Pages
      1878
    • Publisher
      総合医学社
    • ISBN
      9784883785643
    • Related Report
      2019 Research-status Report
  • [Book] 検査値から考える周術期血液凝固異常2017

    • Author(s)
      市川順子
    • Total Pages
      218
    • Publisher
      克誠堂
    • ISBN
      9784771904859
    • Related Report
      2017 Research-status Report

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Published: 2017-04-28   Modified: 2022-01-27  

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