Allain Jean-Pierre, Sibinga Cees Th Smit
Department of Haematology, University of Cambridge, Cambridge, UK.
IQM Consulting for International Development of Quality Management in Transfusion Medicine, Groningen, The Netherlands.
Asian J Transfus Sci. 2016 Jan-Jun;10(1):5-11. doi: 10.4103/0973-6247.164270.
For many years, family blood donors have been considered less safe than volunteer non-remunerated blood donors and actively discouraged by international organisations and affluent countries support agencies for developing countries. In addition to safety, pressure and coercion was considered unethical. However these assumptions were not supported by evidence.
To assemble recently collected evidence to reopen the assessment whether or not the ban of family blood donors is justified.
Review of old and recent literature through Pubmed and references from identified articles.
Viral marker data comparing confirmed seroprevalence in 1(st) time volunteer non-remunerated donors (VNRD) and family/replacement donors (FRD) corrected for gender and age, show no significant difference between the two groups. Evidence has been provided that for both VNRD and FAD benevolence is more appropriate than altruism. The two groups merge for psychological attitude to donation for which knowing someone needing transfusion is a powerful incentive to give blood. Excluding a life or death situation found in areas where severe blood shortage justifies replacement donation, pressures are exerted on both VNRD and FRD. There is no evidence of coercion of FRD. FRDs therefore meet all criteria for VNRD and are willing to become VNRD and to repeat donation. Ostracising FRD is illegitimate and damaging to the blood supply in resource poor areas. In some countries no difference is made between the two groups of donors representing similar populations asked to give blood in different circumstances.
FRDs remain a critical source of volunteer, non-remunerated, blood meeting all classical criteria of VNRD that should be considered legitimate and indispensable at this point in time instead of discouraged.
多年来，家庭献血者一直被认为不如自愿无偿献血者安全，国际组织以及富裕国家为发展中国家提供支持的机构都积极劝阻家庭献血行为。除安全因素外，施压和强迫也被视为不道德。然而，这些假设并无证据支持。
收集近期的证据，重新评估禁止家庭献血者献血是否合理。
通过PubMed检索新旧文献，并参考已识别文章的参考文献。
对首次自愿无偿献血者（VNRD）和家庭/替代献血者（FRD）的病毒标志物数据进行性别和年龄校正后，比较确诊血清阳性率，结果显示两组之间无显著差异。有证据表明，对于VNRD和FAD而言，仁爱比利他主义更合适。两组在献血的心理态度上趋于一致，即知道有人需要输血是献血的强大动力。除了在严重血液短缺地区出现的生死攸关情况，此时替代献血是合理的，VNRD和FRD都会面临压力。没有证据表明FRD受到了强迫。因此，FRD符合VNRD的所有标准，并且愿意成为VNRD并再次献血。排斥FRD是不合理的，并且会损害资源匮乏地区的血液供应。在一些国家，这两类献血者并无区别，他们代表了在不同情况下被要求献血的相似人群。
FRD仍然是志愿无偿献血的重要来源，符合VNRD的所有经典标准，在现阶段应被视为合法且不可或缺，而不是被劝阻。
