Sparrow Rosemary L
Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia.
Blood Transfus. 2017 Mar;15(2):116-125. doi: 10.2450/2017.0326-16.
Quality and safety of red blood cell (RBC) components is managed by screening of donors and strict regulatory controls of blood collection, processing and storage procedures. Despite these efforts, variations in RBC component quality exist as exemplified by the wide range in storage-induced haemolysis. This article provides a brief overview of the variables that contribute or potentially contribute to the quality of stored RBC components, including blood collection, processing, and donor-related variables. Particular focus is made on donor health and lifestyle factors that are not specifically screened and may impact on the physicobiochemical properties of RBCs and their storability. Inflammatory and oxidative stress states may be especially relevant as RBCs are susceptible to oxidative injury. Few studies have investigated the effect of specific donor-related variables on the quality of stored RBC components. Donor-related variables may be unaccounted confounders in the "age of blood" clinical studies that compared outcomes following transfusion of fresher or longer-stored RBC components. The conclusion is drawn that the blood donor is the greatest source of RBC component variability and the least "regulated" aspect of blood component production. It is proposed that more research is needed to better understand the connection between donor-related variables and quality consistency of stored RBC components. This could be very important given the impact of modern lifestyles that sees escalating rates of non-communicable health conditions that are associated with increased oxidative stress, such as hypertension, obesity and diabetes in children and adults, as well as an ageing population in many countries. The effect of these changes to global health and population demographics will impact on blood donor panels, and without significant new research, the consequences on the quality of stored blood components and transfusion outcomes are unknown.
红细胞（RBC）成分的质量和安全性通过对献血者的筛查以及对血液采集、处理和储存程序的严格监管来管理。尽管做出了这些努力，但红细胞成分质量仍存在差异，储存诱导溶血的广泛范围就是例证。本文简要概述了对储存红细胞成分质量有贡献或可能有贡献的变量，包括血液采集、处理和与献血者相关的变量。特别关注未进行专门筛查且可能影响红细胞物理生化特性及其储存性的献血者健康和生活方式因素。由于红细胞易受氧化损伤，炎症和氧化应激状态可能尤其相关。很少有研究调查特定献血者相关变量对储存红细胞成分质量的影响。在比较输注较新鲜或储存时间较长的红细胞成分后的结果的“血液年龄”临床研究中，献血者相关变量可能是未被考虑的混杂因素。得出的结论是，献血者是红细胞成分变异性的最大来源，也是血液成分生产中最缺乏“监管”的方面。建议需要进行更多研究，以更好地理解献血者相关变量与储存红细胞成分质量一致性之间的联系。鉴于现代生活方式的影响，非传染性健康状况的发生率不断上升，这些状况与氧化应激增加有关，如儿童和成人中的高血压、肥胖症和糖尿病，以及许多国家人口老龄化，这一点可能非常重要。这些全球健康和人口结构变化的影响将对献血者群体产生影响，而且如果没有重大的新研究，对储存血液成分质量和输血结果的影响将是未知的。
