Marwaha Neelam
Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Biologicals. 2010 Jan;38(1):68-71. doi: 10.1016/j.biologicals.2009.10.020. Epub 2010 Jan 13.
Data on blood collection, testing and component preparation has improved worldwide; however, there is limited information on blood utilization from the developing countries. Blood requirement in the Southeast Asia region is 15 million units against a collection of 9.3 million. There is huge diversity in the management of blood transfusion services, the voluntary blood collection (range 40-100%) and proportion of blood separated into components (10-95%). The major indications for transfusion are for emergency obstetric care, surgery, pediatric and trauma patients. The prevalence of thalassemia in this region is high and in India alone 2 million units of packed red cells are required for transfusion to these patients. The Blood Safety Program in India has developed as a component of the National Aids Control Program and has lead to infrastructure development, blood component separation facilities and formulation of a National Blood Policy. In order to facilitate emergency obstetric care nearer home, blood storage centers are being established at primary health care centers. Emerging infectious threats like dengue hemorrhagic fever necessitate platelet transfusion therapy. A few centers in India issue NAT screened blood. It is envisaged to establish a nationally co-ordinated transfusion service for cost-effective quality blood/components for appropriate clinical use.
全球范围内,血液采集、检测及成分制备的数据已有改善;然而,关于发展中国家血液利用情况的信息却很有限。东南亚地区的血液需求量为1500万单位,而采集量仅为930万单位。输血服务管理、自愿无偿献血比例(40%-100%不等)以及血液成分分离比例(10%-95%)存在巨大差异。输血的主要适应症是产科急诊、手术、儿科及创伤患者。该地区地中海贫血的患病率很高,仅在印度,就需要200万单位的浓缩红细胞用于这些患者的输血治疗。印度的血液安全计划已作为国家艾滋病控制计划的一部分得以发展,并带来了基础设施建设、血液成分分离设施以及国家血液政策的制定。为了在更靠近家庭的地方提供产科急诊服务,正在初级卫生保健中心设立血液储存中心。登革出血热等新出现的感染威胁使得血小板输血治疗成为必要。印度的一些中心提供核酸检测筛查的血液。预计将建立一个全国协调的输血服务机构,以提供具有成本效益的优质血液/成分用于适当的临床应用。