DRK-Blutspendedienst West gemeinnützige Gesellschaft mit beschränkter Haftung der Landesverbände Nordrhein, Westfalen-Lippe, Rheinland-Pfalz und Saarland, Germany.
Vox Sang. 2012 Feb;102(2):116-24. doi: 10.1111/j.1423-0410.2011.01518.x. Epub 2011 Jul 14.
In view of demographic changes, it is becoming increasingly necessary to make allowance for the fact that older individuals in good health are generally more willing to donate blood and hence they should be allowed to do so irrespective of an upper age limit. In this respect, evidence has to be produced that there is neither an age-related increase in risks to the donor nor any influence on the safety and efficacy of the blood components. It was therefore of interest to examine the quality of therapeutic plasma in relation to a donor's age and also a donor's gender in view of the preferred use of male donor plasma for reducing the risk of transfusion related acute lung injury.
Citrate-phosphate-dextrose (CPD) units of whole blood taken in each case from 50 blood donors (30 men and 20 women) of three age groups (cohort 1 = 69-71 years, cohort 2 = 66-68 years and cohort 3 = 50-52 years) were filtered, centrifuged and then separated into the relevant blood components. The plasma samples were assessed for international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, factor V (FV), factor VIII (FVIII), antithrombin (AT), protein S and plasminogen.
While aPTT showed only slight age-related differences of no significance, the INR levels of cohort 1 were significantly higher than those of cohorts 2 and 3. However, in terms of gender, this applied to male donors only. The differences in INR are demonstrated by lower FV levels of male cohort 1 donors, although this is not statistically significant in comparison with the other two age groups and with female donors. Female donors of all cohorts, however, exhibited noticeably lower aPTT levels than male donors. Lower INR and aPTT values in women could be a sign of a lower dilution affected by CPD anticoagulant as compared to male plasma. An increase in FVIII levels was also apparent with increasing age (P < 0·05), particularly in male donor plasma. The fibrinogen levels suggest a slight, though insignificant, age-related increase and no significant gender-dependent effect. The plasma levels of AT and plasminogen were unremarkable. The plasma of female cohort 3 donors exhibited a protein S concentration that was slightly lower by comparison. Compared with the other two cohorts, cohort 1 plasma levels were similarly above or below the normal range derived from cohort 3 (central 95% range) for all parameters tested.
International Normalized Ratio, aPTT, FVIII, FV, fibrinogen and protein S, as quality indicators for the efficacy of therapeutic plasma, revealed a moderate correlation with age and gender. Compared with the usual reference ranges, the differences were not significant enough to identify any relevant imbalance between procoagulating, anticoagulating and fibrinolytic factors that might influence product quality where the increasing age of the donors or the preference of male donor plasma was concerned.
鉴于人口结构的变化，越来越有必要考虑到身体健康的老年人通常更愿意献血的事实，因此无论年龄上限如何，都应允许他们献血。在这方面，必须证明，献血者的年龄与风险的增加之间没有关系，也不会对血液成分的安全性和有效性产生任何影响。因此，鉴于男性献血者血浆更有利于降低输血相关急性肺损伤的风险，研究与献血者年龄和性别相关的治疗性血浆质量是很有意义的。
从三个年龄组的 50 名献血者（30 名男性和 20 名女性）中各采集枸橼酸盐磷酸盐葡萄糖（CPD）全血单位，分别过滤、离心，然后分离成相关的血液成分。评估血浆样本的国际标准化比值（INR）、活化部分凝血活酶时间（aPTT）、纤维蛋白原、因子 V（FV）、因子 VIII（FVIII）、抗凝血酶（AT）、蛋白 S 和纤溶酶原。
尽管 aPTT 仅显示出略有差异，但无统计学意义，然而，第 1 组的 INR 水平明显高于第 2 组和第 3 组。然而，就性别而言，这种情况仅适用于男性献血者。尽管与其他两个年龄组和女性献血者相比，第 1 组男性献血者的 FV 水平较低，但这在统计学上并不显著。然而，所有年龄组的女性献血者的 aPTT 水平明显低于男性献血者。女性献血者的 INR 和 aPTT 值较低可能是由于 CPD 抗凝剂稀释程度较低所致，与男性血浆相比。FVIII 水平也随着年龄的增加而升高（P<0.05），尤其是在男性献血者血浆中。纤维蛋白原水平表明存在轻微但无统计学意义的年龄相关性增加，且无明显的性别依赖性影响。AT 和纤溶酶原的血浆水平无明显变化。第 3 组女性献血者的蛋白 S 浓度略低。与其他两个队列相比，第 1 队列的血浆水平在所有测试参数上均与第 3 队列（中心 95%范围）的正常范围相似或高于正常范围。
作为治疗性血浆疗效的质量指标，INR、aPTT、FVIII、FV、纤维蛋白原和蛋白 S 与年龄和性别呈中度相关。与常用参考范围相比，差异并不显著，不足以确定在献血者年龄增加或偏好男性献血者血浆的情况下，影响产品质量的促凝、抗凝和纤维蛋白溶解因子之间存在任何相关的不平衡。
