Blood Supply and Demand in Korea: What is in Store for the Future?

노주혜,최승준,김신영,민혁기,김현옥 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.5

Purpose: Presently, Korea is facing new challenges associated with an imbalance in blood supply and demand. The purpose of this study was to examine trends in blood supply and demand in Korea over the past 10 years through 2018 and to propose what to prepare in the future. Materials and Methods: Age demographics in Korea were analyzed using data from the Statistics Korea. Blood donation and blood supply data were analyzed using Blood Services Statistics 2018 by the Korean Red Cross. Blood transfusion data from hospitals in 2018 were obtained from the Health Insurance Review and Assessment Service. Results: In 2018, 2883270 whole blood and apheresis units were collected in Korea. The Korean Red Cross supplied 4277762 blood components to 2491 hospitals. The overall blood donation rate was 5.6%, and the most frequent donors were young male donors. Leukoreduced red blood cells (RBCs) constituted 25% of all RBCs used, and 40% of all platelets were supplied by single-donor platelets. The self-sufficiency rate of domestic plasma with which to produce plasma-derived medicinal products was 68.7% in 2018. Blood use was the most frequent among patients aged 70–79 years. Conclusion: Blood management in Korea is changing rapidly due to a low birth rate, rapid aging, and an increase in severely ill patients who require most of the blood supply. Therefore, future plans to promote donation at a national level and optimal use of blood in hospitals is necessary.

A Study about Peritumoral Brain Edema in Meningiomas using Angiographic Pattern and MIB-1

Chung, Dai-Jin,Hwang, Hyung-Sik,Kim, Sung-Min,Choi, Sun-Kil The Korean Neurosurgical Society 2005 Journal of Korean neurosurgical society Vol.37 No.1

Objective: Peritumoral brain edema(PTBE) accounts for approximately 60% of meningiomas. It has not been identified why vasogenic edema, frequently shown in intra-axial tumors is also developed in extra-axial tumor such as meningiomas. Therefore, the authors assess the peritumoral brain edema of meningiomas with a focus on the angiographic pattern and expression of MIB-1 to clarify their correlation. Methods: A total 32 cases of meningioma was studied. The authors attempted to identify 1) the location of PTBE and the edema index (EI), 2) the location and dominancy of pial supply compared with meningeal supply, 3) the biological activity of meningiomas indicated by the MIB-1 LI (labeling index), 4) their interaction. Results: No PTBE was observed in the meningiomas without pial arterial supplement from internal carotid artery (ICA) and vertebral artery (VA). The PTBE of meningiomas with pial supply was developed intensely along the pial arterial supplement, and increased statistically in proportion to the extent of pial supply from ICA or VA rather than meningeal supply. Also, the MIB-1 LI in meningiomas tended to be larger in the tumors of the larger EI and the dominancy of pial supply. Conclusion: A strong correlation is found between the extent of PTBE in meningiomas and the dominancy of pial supply. The MIB-1 LI also tend to be associated with the PTBE. Therefore, the MIB-1 LI in benign meningiomas may represent not only the proliferative potential of the tumor, but also the biological activity like angiogenesis.

횡복직근 피판술을 이용한 유방 재건에서 구역 2와 구역 3의 지방 괴사의 비교: 전향적 연구

이택종,김은기,윤상엽,장학,손병호,안세현,이무송 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.6

Fat necrosis in transverse rectus abdominis musculocutaneous(TRAM) flaps is considered to be primarily affected by blood supply. Unreliability of blood supply in zone II has been claimed for years but no accurate comparison has been reported between fat necrosis in zone II and III. A prospective study about the incidences and extent of fat necrosis in zone II and III was designed, comparing relative vascularity between zone II and III. Immediate breast reconstructions after modified radical mastectomy or skin sparing mastectomy were performed in 150 consecutive patients with unipedicled TRAM flaps and 138 contralateral and 12 ipsilateral rectus muscles were used as pedicles. Twenty-one patients(14 percent) suffered from fat necrosis and 22 fat necroses were diagnosed in total. 17 fat necroses occurred in zone II, 3 in zone III and 2 in zone I. The incidence of fat necrosis in zone II was significantly higher than zone III, which was consistent with previous studies claiming poor vascularity of zone II. Therefore placing zone I and zone III medially and zone II laterally after discarding part of zone II will cause less deformity of reconstructed breast if resection of necrotized tissue is needed.

국내 혈액 센터에서의 혈액 적정 재고량 유지를 고려한 이동식 헌혈 시설의 운영 최적화 사례 연구

고다영,임동하,송진영,이은혜,한진일 한국경영과학회 2018 經營 科學 Vol.35 No.4

The inventory management in the blood center is still challenging due to the uncertainties related to blood supply and perishability of the blood products. In particular, the uncertainty originated from blood supply is hard to mitigate because blood can only be obtained from voluntary donation from blood donors. To increase blood donation, mobile blood donation facilities such as blood donation buses have widely been used all over the world since they can attract potential blood donors. However, the systematic scheduling of such mobile donation facilities is not yet adequately applied in practice. In this paper, we propose a mixed integer programming formulation that determines optimal schedules of mobile blood donation facilities while taking into account the inventory management in the blood center. Our case study is conducted on real-world instances of a Korean blood center. The results show that optimized schedules obtained from our model can significantly reduce total costs compared to two heuristic scheduling algorithms.

골든 타임을 고려한 신속한 혈액 공급사슬 설계

김성일 ( Sungil Kim ),김준 ( Jun Kim ),김현정 ( Hyunjung Kim ),정병도 ( Byungdo Chung ) 한국로지스틱스학회 2016 로지스틱스연구 Vol.24 No.4

각 지역의 혈액원이 인근에 위치한 병원에 혈액을 공급하는 현재의 혈액 공급 체계에서는 긴급하게 혈액이 필요한 응급 상황 발생 시, 필요한 혈액을 신속하게 배송하기 어렵다. 특히 혈액원에서 한 시간 이상의 거리에 위치한 병원들은 수혈이 늦어지는 경우 환자의 치료 결과에 부정적인 영향을 미칠 수 있다. 본 연구에서는 기 존 병원 중 일부를 혈액 분배 병원으로 지정하고, 주변에 위치한 병원들에게 빠르게 혈액을 배송할 수 있는 새로운 혈액 공급 사슬 체계를 제안한다. 기존 병원들 중 혈액 분배 병원을 선정하고, 혈액 분배 병원에 인근 병 원을 할당하기 위해 Minimax 최적화 모델을 개발하였다. 경상북도에 위치한 병원 중 응급 의료기관으로 지정 된 병원들을 대상으로 실제 데이터를 수집하여 수치실험을 진행하였다. 응급상황에 대응하기 위해서는 최소 5 개 이상의 병원들이 혈액 분배 병원으로 지정되어야 함을 알 수 있었으며, 민감도 분석을 통하여 의사결정의 기준을 제공하였다. Under emergency circumstances, a hospital requires a large amount of blood and a regional blood services center is not able to supply the blood to hospitals urgently. In particular, hospitals taking more than one hour from the regional blood services center cannot give a transfusion into patients, which will result in critical impact on the treatment. This paper aims to supply blood quickly to hospitals by developing a new agile blood supply chain system. We develop a minimax mathematical model for assigning regional hospitals to blood distribution hospitals and grouping hospitals based on the assigned blood distribution hospitals. Numerical experiments are conducted with the data about hospitals in Gyeongsangbuk-do, Korea. An in-depth analysis is carried out by changing the number of blood distribution hospitals and comparing the minimax model with a minisum model. Our results show that the number of the blood distribution hospitals should be greater than five and the minimax model is suitable for emergency response.

혈액공급체인상의 SCM도입 성공요인에 대한 연구

김창봉(Chang-bong Kim),박상안(Sang-an Park) 한국인터넷전자상거래학회 2008 인터넷전자상거래연구 Vol.8 No.4

This is a case study on a blood transportation system of blood supply chain in the U.K and Japan. By adopting the PULSE system, U.K improved its supply chain of NBS and it also contributed to eliminate man's error of inventory tracing and dealing process. Blood transportation system outsourced professional transportation company of blood in Japan. In consequence, it obtained just-in-time blood supply as well as in cost reduction. Therefore, we should accept the developed country's strong points to supply the blood in a timely manner to work off one's frustration, reduce its transportation cost, and elevate the result The final aim is to increase the efficiency of blood transportation.

채혈금지대상자 기준에 대한 국내 혈액원 의사의 의견수렴을 위한 설문조사 연구

박서진,김명희,김선형,신정원,김현경,이상원,신영희,임영애 대한수혈학회 2010 大韓輸血學會誌 Vol.21 No.3

Background: The donor selection criteria should ensure the safety of both the donors and the recipients of blood products. However, modifications may help promote more blood donors in keeping with the rapidly aging Korean population. Our goal was to gather opinions of the medical staff at blood centers on the current donor selection criteria. Methods: A survey was sent out via email to 55 medical staff at hospital blood banks, the Korean Red Cross and Hanmaeum blood centers. The survey included 14∼16 questions regarding age, weight, donation volume, donation interval and frequency, hemoglobin, blood pressure, pulse rate, and the level of alanine aminotransferase (ALT). Results: Survey responses from 38 out of 55 (69.1%) medical staff were analyzed. The donor selection criteria that showed significantly higher acceptable rates included the upper age limit (71%, P=0.009) and whole blood donation frequency and intervals (68%, P=0.023). The ALT level showed the highest unacceptable rate (84%, P<0.0001) and other criteria with significantly higher unacceptable rates included donor weight (68%, P=0.023) and donation volume (76%, P=0.001). Responses from medical staff at supply blood banks and hospital blood banks showed a significant difference regarding the use of parent/guardian consent forms in blood donors that were 16 years or younger (75% versus 41%, respectively; P=0.0368). Conclusion: This study outlines the perspectives of medical staff at blood centers regarding the current donor selection criteria. According to the survey, the ALT level, donor weight, and donation volume should be considered for revision. These results can be referenced in the future when proposing modifications to the donor selection criteria. 배경: 헌혈자 선별기준은 헌혈자와 수혈을 받는 헌혈자의 안전성을 최대한 보장하는 것이 가장 중요하다. 특히 국내도 고령화 사회로 접어들면서 헌혈자원 확대에 대한 검토가 필요하다. 따라서 본 연구에서는 현재의 헌혈자 선별기준 항목의 적절성에 대하여 설문조사를 통하여 국내혈액원 의사들의 의견을 수렴하였으며 외국 기준들과 비교분석하여 선별기준 개선에 도움을 주고자 하였다. 방법: 대한적십자사 및 한마음 혈액원과 연간50단위 이상 제조하는 의료기관혈액원에 근무하는 의사 55명을 대상으로 헌혈자 선별기준에 대한 14∼16개의 문항에 대하여 적절 또는 부적절여부를 묻는 설문조사를 이메일을 통하여 실시하고 통계처리를 하여 자료를 분석하였다. 결과: 회신율은 69.1% (38/55)로 현재 선별기준중 상한연령(71%, P=0.009)과 전혈 헌혈빈도 및간격(68%, P=0.023)은 적절하다는 의견이 우세하였고, ALT(84%, P<0.0001)는 부적절하다는 의견이 가장 높았으며, 그 밖에 체중(68%, P=0.023)과채혈량(76%, P=0.001)도 현재 기준이 부적절하다는 의견이 유의하게 높게 나타났다. 또한 16세 이하의 헌혈자에 대해서 부모 또는 보호자 동의서를추가에 동의하는 의견은 의료기관혈액원(41%)에비해 공급혈액원(75%)에서 월등히 높게 나타났다(P=0.0368). 결론: 현재의 헌혈자 선별기준에 대한 설문조사를 통해 헌혈자 상한연령, 전혈 헌혈빈도 및 간격과 같이 적절하다고 생각하는 항목과 ALT 수치, 헌혈자 체중, 그리고 채혈량과 같이 개선을고려해야 하는 항목들에 대한 혈액원 의사들의의견을 수렴할 수 있었다. 이는 향후 헌혈자 선별기준 개선(안)을 제시하는데 도움을 줄 것으로 여겨졌다.

Optimizing the Issue of Blood Supply Chain Network Design with a Reliability Approach

Anik Yuesti,Paitoon Chetthamrongchai,Alim Al Ayub Ahmed,Vera Anitra,Surendar Aravindhan,Ravil Akhmadeev,Dedy Achmad Kurniady,Clara Neltje Meini Rotinsulu,M. Kavitha 대한산업공학회 2022 Industrial Engineeering & Management Systems Vol.21 No.2

Supply chain network design of a product is one of the primary and strategic measures in supply chain management that plays a vital role in supply chain performance. Since blood is a special commodity and has no substitute, supply chain management and optimization have a special place among researchers. In this research, for the first time, a two-objective nonlinear mixed integer model is presented to help make strategic and operational decisions in the blood supply chain. The first objective function is related to cost minimization and the second objective function is related to supply chain reliability maximization, which is considered as a series-parallel system. To check the validity of the model, a numerical example is solved using GAMS software, then using MOPSO meta-heuristic algorithm, the model is solved in larger dimensions and while comparing the performance criteria of multi-objective algorithms, the results are reviewed.

e-SCM구축정도에 따른 국내 혈액원들 간의 상대적인 효율성 평가에 관한 연구

김창봉(Chang-bong Kim),박상안(Sang-an Park) 한국인터넷전자상거래학회 2009 인터넷전자상거래연구 Vol.9 No.2

Data Envelopment Analysis(DEA) is a methodology of computing the relative efficiency of each decision making unit(DMU) by comparing it with other DMUs having similar input and output structure. In this study, we compare the efficiency of sixteen blood center of the Republic of Korea National Redcross using DEA. Several evaluations have been carried out by means of the input oriented CRS model, and the results indicate that Jeju blood center is the efficient DMU. But, blood supply chain of Jeju blood center is inapplicable to other blood centers because of scale and peculiar structure. Therefore, we suggest the next best model for our results that central and gwangju?jeonnam blood centers followed with 0.847 and 0.881 respectively. The large scale blood centers such as central blood center is more efficient to direct transportation by staff of blood center, on the other hand, blood center with wide region such as gwangju?jeonnam blood center is more efficient to transport by callvan, bus, taxi and door-to-door delivery service.

국가 혈액수급감시체계의 전수감시에 대한 의료기관의 준비현황에 대한 설문조사

천세종,최지선,정영준,신정원,정경은,오진아,김준년,임영애 대한수혈학회 2020 大韓輸血學會誌 Vol.31 No.3

Background: The current Korean Blood Inventory Monitoring System (BMS) has several drawbacks. It does not provide real-time data and only monitors 211 of the more than 2500 institutes that performed blood transfusions. This survey study investigated the status of BMS use and the preparation status of the data input system of medical institutions to help in the revision of BMS in preparation for the full surveillance of BMS. Methods: A survey questionnaire was given to 200 hospitals participating in the current BMS, along with another set of questionnaires to 150 non-participating hospitals. The questionnaire consisted of the method of data registry to BMS, the current status of electronic medical records (EMR) and order communication system (OCS), perception, and readiness of adaptation of an open application programming interface system (API). Results: Two hundred and one BMS participating hospitals responded to the survey. Approximately 75% entered data with a comma-separated value (CSV) or Excel spreadsheet (xls) files, and approximately half had an in-house developed EMR and OCS. The majority showed enthusiasm for the introduction to an open API. Among the non-participating hospitals, 138 responded. Approximately 70% counted the blood inventory daily, but approximately half did not use electronic methods for this process. The response to the introduction to an open API was positive, but the readiness for a prompt introduction was low at 15.9%. Conclusion: These results will help revise the current BMS. On the other hand, full surveillance of BMS is anticipated to be hindered by the ready state of each medical institute. Moreover, the encouragement of participation would require supportive government administrative measures.