Clinical Services and Research, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.
Clinical Services and Research, Australian Red Cross Blood Service, Brisbane, Queensland, Australia.
Transfusion. 2019 Oct;59(10):3157-3163. doi: 10.1111/trf.15475. Epub 2019 Aug 12.
This study examined the impact of donor adverse events (DAEs) on plasma donor return and compared these against trends in whole blood (WB) donors.
Using a retrospective cohort design, donors who attempted to give plasma or WB in 2014-2015 were categorized by DAE and followed for 2 years. Analyses of return rate, time to return, subsequent donation frequency, and recurrent risk were performed. Donor characteristics associated with return were also assessed.
For both plasma and WB donors, vasovagal reactions (VVRs) were the strongest deterrent to return, with a lower proportion returning, taking longer to return, and making fewer subsequent donations than those with uncomplicated donations. Despite a higher likelihood of a recurrent event among those who experienced a DAE, the majority had an uncomplicated subsequent donation. Donor characteristics associated with return varied by phlebotomy and DAE type. For donors experiencing a VVR, differences were observed by donor experience, age, sex, and site type between plasma and WB. For phlebotomy-injured donors, differences were observed by sex, blood type, donor experience, and donation outcome between the two groups. No factors associated with return after a citrate reaction were found.
This study highlights the detrimental effects of DAEs on plasma return, in particular VVRs, and the differences in factors associated with return compared to WB donors. Further research is required to understand the mechanisms underlying the decision to return following a DAE.
本研究考察了供体不良事件(DAE)对血浆供体返回的影响,并将其与全血(WB)供体的趋势进行了比较。
使用回顾性队列设计,根据 DAE 将 2014-2015 年试图捐献血浆或 WB 的供体进行分类,并随访 2 年。分析了返回率、返回时间、后续捐献频率和复发风险。还评估了与返回相关的供体特征。
对于血浆和 WB 供体,血管迷走神经反应(VVR)是返回的最强阻碍因素,返回的比例较低,返回时间较长,随后的捐献次数也较少,与无并发症的捐献相比。尽管经历 DAE 的供体再次发生事件的可能性较高,但大多数供体随后的捐献仍无并发症。与返回相关的供体特征因采血和 DAE 类型而异。对于经历 VVR 的供体,在血浆和 WB 之间观察到供体经验、年龄、性别和采血部位类型的差异。对于采血损伤供体,在两组之间观察到性别、血型、供体经验和捐献结果的差异。未发现与柠檬酸反应后返回相关的因素。
本研究强调了 DAE 对血浆返回的不利影响,特别是 VVR,以及与 WB 供体相比,与返回相关的因素的差异。需要进一步研究以了解 DAE 后决定返回的机制。