Funk M B, Günay S, Lohmann A, Henseler O, Keller-Stanislawski B
Referat S2 Pharmakovigilanz II, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2010 Apr;53(4):347-56. doi: 10.1007/s00103-010-1037-8.
On the basis of reports of serious transfusion reactions, measures aimed to improve the safety standard of the manufacturing process of blood components were evaluated from 1997-2008. Measures of the Paul-Ehrlich-Institut (PEI) as well as recommendations of the Advisory Committee "Blood" were considered. Reporting frequencies before and after the implementation of measures were compared. After the implementation of NAT pool testing, a reduction of virus transmission was seen for red blood cell concentrates (RBC) from 1.0/10(6) to 0.5/10(6) units and for platelet concentrates (PC) from 3.0/10(6) to 0.0/10(6) units. After the implementation of a pre-donation sampling, however, no reduction of bacterial infections associated with PC administration (>9.0/10(6)) was identified. To reduce the frequency of TRALI associated with FFP administration (11.2/10(6) units), the use of plasma from male donors or female donors without a history of pregnancy was established in September 2009. Without specific measures of risk reduction, the reporting frequency of severe allergic transfusion reaction increased for all blood components during the investigation period (from 0.8/10(6) to 6.2/10(6) RBC units). The benefit of measures to improve safety standards should be evaluated repeatedly by collecting precise hemovigilance data.
基于严重输血反应的报告,从1997年至2008年对旨在提高血液成分制造过程安全标准的措施进行了评估。考虑了保罗·埃利希研究所(PEI)的措施以及“血液”咨询委员会的建议。比较了措施实施前后的报告频率。实施核酸扩增检测(NAT)混合检测后,红细胞浓缩物(RBC)的病毒传播率从1.0/10⁶单位降至0.5/10⁶单位,血小板浓缩物(PC)的病毒传播率从3.0/10⁶单位降至0.0/10⁶单位。然而,实施献血前采样后,未发现与PC输注相关的细菌感染率降低(>9.0/10⁶)。为降低与新鲜冰冻血浆(FFP)输注相关的输血相关急性肺损伤(TRALI)发生率(11.2/10⁶单位),2009年9月开始使用男性献血者或无妊娠史女性献血者的血浆。在调查期间,在没有具体风险降低措施的情况下,所有血液成分的严重过敏输血反应报告频率均有所增加(从0.8/10⁶红细胞单位增至6.2/10⁶)。应通过收集精确的血液警戒数据反复评估提高安全标准措施的效益。