Greinacher Andreas, Weitmann Kerstin, Schönborn Linda, Alpen Ulf, Gloger Doris, Stangenberg Wolfgang, Stüpmann Kerstin, Greger Nico, Kiefel Volker, Hoffmann Wolfgang
Institut für Immunologie und Transfusionsmedizin and.
Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Germany.
Blood Adv. 2017 May 26;1(14):867-874. doi: 10.1182/bloodadvances.2017005876. eCollection 2017 Jun 13.
Transfusion safety includes the risk of transmission of pathogens, appropriate transfusion thresholds, and sufficient blood supply. All industrialized countries experience major ongoing demographic changes resulting from low birth rates and aging of the baby boom generation. Little evidence exists about whether future blood supply and demand correlate with these demographic changes. The ≥50% decline in birth rate in the eastern part of Germany after 1990 facilitates systematic study of the effects of pronounced demographic changes on blood donation and demand. In this prospective, 10-year longitudinal study, we enrolled all whole blood donors and all patients receiving red blood cell transfusions in the state of Mecklenburg-West Pomerania. We compared projections made in 2005 based on the projected demographic changes with: (1) number and age distribution of blood donors and transfusion recipients in 2015 and (2) blood demand within specific age and patient groups. Blood donation rates closely followed the demographic changes, showing a decrease of -18% (vs projected -23%). In contrast, 2015 transfusion rates were -21.3% lower than projected. We conclude that although changes in demography are highly predictive for the blood supply, transfusion demand is strongly influenced by changes in medical practice. Given ongoing pronounced demographic change, regular monitoring of the donor/recipient age distributions and associated impact on blood demand/supply relationships is required to allow strategic planning to prevent blood shortages or overproduction.
输血安全包括病原体传播风险、适当的输血阈值以及充足的血液供应。所有工业化国家都因低出生率和婴儿潮一代的老龄化而经历着持续的重大人口结构变化。关于未来血液供应和需求是否与这些人口结构变化相关，几乎没有证据。1990年后德国东部出生率下降≥50%，这有助于系统研究显著的人口结构变化对献血和需求的影响。在这项为期10年的前瞻性纵向研究中，我们纳入了梅克伦堡-前波美拉尼亚州的所有全血捐献者和所有接受红细胞输血的患者。我们将2005年根据预计人口结构变化所做的预测与以下两项进行了比较：（1）2015年献血者和输血接受者的数量及年龄分布；（2）特定年龄和患者群体内的用血需求。献血率紧密跟随人口结构变化，下降了-18%（预计下降-23%）。相比之下，2015年的输血率比预测值低-21.3%。我们得出结论，尽管人口结构变化对血液供应具有高度预测性，但输血需求受医疗实践变化的强烈影响。鉴于持续显著的人口结构变化，需要定期监测献血者/受血者的年龄分布以及对血液供需关系的相关影响，以便进行战略规划，防止血液短缺或生产过剩。
