Ziemann Malte, Steppat Dagmar, Brockmann Christian, Washington Gesa, Kirchner Holger, Schlenke Peter
Institute of Immunology and Transfusion Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Transfusion. 2006 Dec;46(12):2176-83. doi: 10.1111/j.1537-2995.2006.01049.x.
Usually, a predonation hemoglobin (Hb) measurement must precede blood donation. Hb values of a donor's previous donation might be used for selecting a subgroup in which predonation Hb measurements are unnecessary.
Only donors with historical Hb values below 129 or 139 g per L for female and male donors, respectively, underwent venous Hb measurement before phlebotomy with an automated hematology analyzer. All other donor phlebotomies were collected without initial Hb testing. Hb values from diversion samples from 81,913 consecutive donors between May 2003 and November 2005 were subsequently analyzed as representing their present values. Donors were grouped according to interdonation intervals of less than 6, 6 to 11, 12 to 23, and 24 months or more.
The arithmetic mean deviation between historical and present Hb values was between -0.3 and +1.8 g per L for each group (mean deviation, 5.2-6.7 g/L). Not testing selected donors spared 77.7 percent from a prephlebotomy Hb measurement and showed a specificity of 29 percent. Sensitivities for detection of donors below Hb limits (between 56% and 67% for the different subgroups) and donors with Hb values below 110 g per L (82%-88%) were at least comparable to capillary Hb screening. A total of 4.8 percent of donors were phlebotomized with values below 125 and 135 g per L, whereas only 0.016 percent of donors were bled despite Hb levels below 110 g per L.
Selecting donors for a current Hb measurement based upon their last whole-blood predonation Hb value is a useful method, even after prolonged interdonation intervals.
通常,献血前必须先测量血红蛋白(Hb)。献血者之前献血时的Hb值可用于选择一个无需进行献血前Hb测量的亚组。
仅女性和男性献血者之前的Hb值分别低于129g/L或139g/L的献血者,在采血前使用自动血液分析仪进行静脉Hb测量。所有其他献血者的采血均未进行初始Hb检测。随后对2003年5月至2005年11月期间81913名连续献血者的分流样本中的Hb值进行分析,以代表他们当前的Hb值。根据献血间隔时间将献血者分为小于6个月、6至11个月、12至23个月以及24个月及以上几组。
每组历史Hb值与当前Hb值之间的算术平均偏差在-0.3至+1.8g/L之间(平均偏差为5.2 - 6.7g/L)。不对选定的献血者进行检测,使77.7%的献血者无需进行采血前Hb测量,特异性为29%。检测低于Hb限值的献血者(不同亚组的灵敏度在56%至67%之间)以及Hb值低于110g/L的献血者(82% - 88%)的灵敏度至少与毛细血管Hb筛查相当。共有4.8%的献血者采血时Hb值低于125g/L和135g/L,而尽管Hb水平低于110g/L,但仅有0.016%的献血者被采血。
根据献血者上次全血献血前的Hb值选择当前进行Hb测量的献血者是一种有用的方法,即使在较长的献血间隔之后也是如此。