Patient rescue and blood utilization in the Ogasawara blood rotation system

Igarashi, Tomoko; Fujita, Hiroshi; Asaka, Hiroyuki; Takada, Yuko; Ametani, Rieko; Naya, Ian; Tanaka, Yasushi; Kamesaki, Makoto; Kasai, Asuka

doi:10.1111/trf.14444

Cited by 16 publications

(18 citation statements)

References 14 publications

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“…However, delivery to islands without land transportation is difficult, and during a disaster, there is an increased risk of unfavorable circumstances (e.g., delivery across terrain where bridges have collapsed or across rivers which have overflowed). Shipment of blood, which takes 25 hours or more for the Ogasawara Islands, was done in active transport refrigerators (ATRs) [5]. The ATR is a convenient blood transport system, but it is associated with certain risks, especially during marine transportation, due to turbulence during storms or seasonal variations.…”

Section: Introductionmentioning

confidence: 99%

The Quality of Blood is not Affected by Drone Transport: An Evidential Study of the Unmanned Aerial Vehicle Conveyance of Transfusion Material in Japan

Yakushiji

Murata

et al. 2020

Drones

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Unmanned aerial vehicles (UAVs), or drones, are used in Rwanda for transfusion transport, but they have not yet been used in Japan. This technology holds promise for transporting medical supplies during disasters or to remote places where the terrain makes it difficult to travel by land. One of the difficulties in using UAVs is the temperature-control requirements for red blood cell (RBC) solutions, i.e., 2 °C to 6 °C according to Japanese regulations. This study aimed to describe the effectiveness of UAV-based transport of RBC solution. For testing, we gradually increased the UAV travel distance, monitored the temperature of the RBC solution, and conducted laboratory tests to check the integrity of the blood sample. Lactate dehydrogenase (LD) was used as a hemolytic index to indicate the effect of the UAV flight on the blood samples. The UAV was able to exceed 7 km of travel distance despite the relatively heavy load needed for the RBC solution storage. The LD level was not significantly different between the flight and non-flight (control) samples. However, we were not able to completely maintain a temperature of 2 °C to 6 °C; nonetheless, the deviation was within the safe range.

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Section: Introductionmentioning

confidence: 99%

The Quality of Blood is not Affected by Drone Transport: An Evidential Study of the Unmanned Aerial Vehicle Conveyance of Transfusion Material in Japan

Yakushiji

Murata

et al. 2020

Drones

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“…Drone blood transportation is being adopted in actual practice, and operations begun in Africa in 2018. 21 Igarashi et al 22 began transporting blood by sea in Japan over a distance of 1,000 km to Ogasawara Island. They achieved storage temperatures of 2-6°C and established long-distance transport by ship.…”

Section: History Of Blood Storage and Transportmentioning

confidence: 99%

“…It was also found that the blood did not undergo hemolysis, most likely due to the temperature control. 22 When considering the conditions necessary for blood transportation, it is important to remember that based on the International Society of Blood Transfusion proposal, Tocchetti et al summarized that the temperature should be 2-6°C, and it must not be below 1°C. 23 Temperature control is mandatory, as described above.…”

Section: History Of Blood Storage and Transportmentioning

confidence: 99%

Blood transportation using multi-vehicle systems; optimal blood transport temperature in terms of hemolysis

Yakushiji¹,

Yakushiji²,

Murata³

et al. 2021

HTIJ

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Recently, the use of drones has been proposed for blood transportation. Therefore, in this review, we first detailed the history of blood storage and transportation for red blood cell transfusion, and then presented ideas for creating rules to improve the safety of blood transportation, based on the idea that hemolysis is the problem for blood quality. In particular, it touches on the current logistics of blood transportation in which public transportation is not used, including the recent use of drones to transport blood, and points out the problems with this system. We discuss how instances of improper red blood cell transportation with inadequate temperature control are still observed, and that temperature control, vibration remain the major hindrances to appropriate blood transportation. Therefore, a set of rules that will contribute to appropriate and rapid blood transportation is warranted. Moreover, there are notable differences in blood storage rule between Japan and the US and UK, and there is no legal transportation rule in Japan. Based on our review and experience, we think that basic temperature control at 2–6°C should always be maintained to prevent blood deterioration even if unmanned aerial vehicle (drone) technologies are available.

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“…Although blood is known to hemolyze through external force and vibration, 3 we confirmed that there was no hemolysis of blood transported by ship at the start of the Ogasawara blood rotation. 4 We believe that a parachute should be attached to reduce the shock when dropping the blood. However, we consider that dropping blood using a parachute may not reduce the shock sufficiently.…”

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confidence: 99%

The quality of blood dropped from an unmanned aerial vehicle (Drone)

Yakushiji¹,

Yakushiji²,

Fujita³

2020

HTIJ

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Objective: To evaluate the risk of deterioration in the quality of blood transported by a fixed-wing drone. Materials and methods: Red blood cell (RBC) solutions were categorized into “travel group” (transported by train or car to test place) and “non-travel” group. The travel group was further subcategorized into “dropped,” and “non-dropped” groups. One bag each from the dropped and non-dropped groups were wrapped in an Absorption Sheet (A-Sheet) and an Under Sheet (U-Sheet). RBC solution of dropped group was dropped onto the ground from an altitude of 10 Lactate dehydrogenase (LD) levels from the samples of RBC solution were measured and the LD ratio (LDR) was calculated as the rate of increase of the LD which can be compared. We compared the differences in LDR between the dropped and non-dropped groups. Results: In the dropped group, there was an increase in LDR before filtration in the blood wrapped in the A-sheet. No increase was noted in the blood wrapped in the U-sheet. LDR levels after filtration were slightly increased in the blood samples wrapped in the U-sheet and clearly increased in blood samples wrapped in the A-Sheet. Conclusion: We considered the possibility of blood getting hemolyzed due to a fall and observed that hemolysis was affected by packing. Thus, since it may be difficult to find good packaging for blood, dropped blood may not be safe for transfusion due to the likelihood of hemolysis. Hence, for practical purposes, using a drone without a fixed-wing may be preferable for transportation of blood.

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Patient rescue and blood utilization in the Ogasawara blood rotation system

Abstract: The Ogasawara BR system was effectively capable of delivering RBC solution for transfusion in patients residing in distant islands and contributed to reducing the wastage of RBC solution by facilitating blood utilization at another hospital.

Cited by 16 publications

References 14 publications

The Quality of Blood is not Affected by Drone Transport: An Evidential Study of the Unmanned Aerial Vehicle Conveyance of Transfusion Material in Japan

The Quality of Blood is not Affected by Drone Transport: An Evidential Study of the Unmanned Aerial Vehicle Conveyance of Transfusion Material in Japan

Blood transportation using multi-vehicle systems; optimal blood transport temperature in terms of hemolysis

The quality of blood dropped from an unmanned aerial vehicle (Drone)

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