Yuan Shan, Gornbein Jeffrey, Smeltzer Barbara, Ziman Alyssa F, Lu Qun, Goldfinger Dennis
Department of Pathology and Laboratory Medicine and Biomathematics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Transfusion. 2008 Jun;48(6):1213-9. doi: 10.1111/j.1537-2995.2008.01674.x. Epub 2008 Mar 13.
Legitimate concerns exist over the safety of donors during multicomponent apheresis collections (MACs), when large volumes of red blood cells (RBCs) and plasma are removed. This study evaluates the predictive value of various donor- and procedure-related variables for moderate to severe donor acute adverse events (AAEs).
Data on all apheresis donation procedures performed at a large university hospital-based donor center over a 2-year period were obtained by a review of adverse event forms and procedure logs (Trima Accel 5.1, Gambro BCT). Various donor- and procedure-related variables were compared between procedures that resulted in moderate to severe AAEs and those that did not.
Moderate to severe AAEs occurred in 53 (0.47%) of 11,333 apheresis donation procedures. The majority of events (96.2%) had predominantly features of vasovagal reactions (VVRs). Females were at significantly higher risk (odds ratio [OR] = 2.8, p < 0.0003) compared to males. Donors who experienced AAEs had significantly lower predonation total blood volume (TBV) and hematocrit (Hct) and higher total RBC loss and net fluid loss at the end of the procedures. Total plasma loss alone was not significantly different between the two groups. Total blood loss was significantly higher among donors who experienced AAEs as a percentage of the donor's TBV.
Apheresis collections are well tolerated even when multiple components are collected, with a very low overall incidence of moderate to severe AAEs (0.47%). Small, female donors with lower predonation Hct are at higher risk, especially when RBCs are collected.
在多成分单采术采集（MACs）过程中，当大量红细胞（RBCs）和血浆被采集时，供者的安全性存在合理担忧。本研究评估了各种供者及操作相关变量对中度至重度供者急性不良事件（AAEs）的预测价值。
通过回顾不良事件表格和操作记录（Trima Accel 5.1，甘布罗BCT公司），获取了一所大型大学附属医院供者中心在2年期间内所有单采术献血操作的数据。比较了导致中度至重度AAEs的操作与未导致此类事件的操作之间各种供者及操作相关变量。
在11333例单采术献血操作中，53例（0.47%）发生了中度至重度AAEs。大多数事件（96.2%）主要表现为血管迷走神经反应（VVRs）。与男性相比，女性的风险显著更高（优势比[OR]=2.8，p<0.0003）。发生AAEs的供者术前总血容量（TBV）和血细胞比容（Hct）显著更低，且在操作结束时总红细胞丢失量和净液体丢失量更高。两组之间仅总血浆丢失量无显著差异。发生AAEs的供者的总失血量占供者TBV的百分比显著更高。
即使采集多种成分，单采术采集的耐受性良好，中度至重度AAEs的总体发生率非常低（0.47%）。术前Hct较低的瘦小女性供者风险更高，尤其是在采集RBCs时。
