Lotfi Ramin, Wernet Dorothee, Starke Uwe, Northoff Hinnak, Cassens Uwe
Department of Transfusion Medicine, Eberhard Karls University, Tuebingen, Germany.
Transfusion. 2005 Oct;45(10):1585-92. doi: 10.1111/j.1537-2995.2005.00574.x.
The reliability of capillary hemoglobin (Hb) as an indicator for eligibility to donate blood is discussed controversially. Therefore, a noninvasive alternative with acceptable predictive values was established and evaluated.
Donor candidates were selected according to their Hb level. The first donation was performed 6 weeks after this selection step. A venous blood sample was collected from all donors at the end of their donation and a postdonation Hb determination was performed. Donors with acceptable postdonation Hb values were permitted to donate next time without any predonation Hb measurement. Donors with low postdonation Hb values were permitted to donate only after a venous Hb measurement had shown an acceptable value. Sensitivity and specificity were determined by comparing the gold standard (i.e., venous Hb measurement) with the presented method of Hb estimation for 19,534 donors.
Taking the postdonation Hb as an indicator for eligibility saved 97 percent of donors from being tested unnecessarily by capillary Hb measurement. This procedure resulted in a specificity of 92.6 percent and a sensitivity of 37.9 percent for Hb cutoff levels of 135 and 125 g per L for men and women, respectively. The sensitivity increased rapidly to 100 percent for Hb levels below 105 g per L. The average deviation from true Hb level was 6 g per L.
The presented noninvasive method distinctly saves time and expenditure without endangering blood donors.
关于毛细血管血红蛋白(Hb)作为献血资格指标的可靠性存在争议。因此,建立并评估了一种具有可接受预测值的非侵入性替代方法。
根据Hb水平选择献血候选人。在这一选择步骤6周后进行首次献血。在所有献血者献血结束时采集静脉血样本,并进行献血后Hb测定。献血后Hb值可接受的献血者下次献血时无需进行任何献血前Hb测量。献血后Hb值低的献血者只有在静脉Hb测量显示值可接受后才允许献血。通过将金标准(即静脉Hb测量)与所提出的19534名献血者的Hb估计方法进行比较,确定敏感性和特异性。
将献血后Hb作为合格指标,使97%的献血者无需进行毛细血管Hb测量的不必要检测。对于男性和女性,Hb临界值分别为135 g/L和125 g/L时,该程序的特异性为92.6%,敏感性为37.9%。当Hb水平低于105 g/L时,敏感性迅速升至100%。与真实Hb水平的平均偏差为6 g/L。
所提出的非侵入性方法显著节省了时间和费用,同时不会危及献血者。