脳ドックで見つかった脳動脈瘤手術に際しての自己血輸血の使用

Transfusion of autologous deposited blood in support of surgery for cerebral aneurysm evaluated by screening for occult intracranial disease

I．はじめに

　輸血（同種血輸血）の使用においては，献血者のスクリーニング検査の強化など安全性を高める努力がされてはいるが，輸血後肝炎や輸血後GVHD（graft versus host disease）などの危険は完全には回避できない．これら同種血輸血によるリスクを避けるために，自己血輸血の普及が望まれている．今回われわれは，脳ドックにて発見された脳動脈瘤の開頭手術に際して，不測の事態による出血に対する輸血として自己血輸血を選択し，準備した．その意義についての考察を加え，報告した．

Preoperatively donated autologous blood was trans-fused during surgery of an unruptured cerebral aneurysm in a 63-year-old banker to avoid allogeneic blood exposure. The aneurysm in this case was evalu-ated by noninvasive screening for occult intracranial disease. The transfusion was based on the Red Cross Blood Transfusion Service autologous donor program-me for regional hospitals.

Preoperative autologous blood donation has con-tinued to grow to reduce risks such as infectious dis-ease transmission and post-transfusion graft-versus-host disease. It is an alternative transfusion practice that should become a standard of care for elective neuro-surgery especially in preventive medicine.