Gress Kyle L, Charipova Karina, Urits Ivan, Viswanath Omar, Kaye Alan D
Georgetown University School of Medicine, Washington, DC.
Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA.
J Patient Cent Res Rev. 2021 Apr 19;8(2):121-126. eCollection 2021 Spring.
While transfusion of blood and blood products is instinctively linked to the provision of emergent care, blood and blood products are also routinely used for the treatment of subacute and chronic conditions. Despite the efforts of the World Health Organization and others, developing countries are faced with a three-part problem when it comes to access to and delivery of transfusions: insufficient supply, excessive demand, and inadequate quality of available supply. Developing countries rely heavily on replacement and remunerated donors rather than voluntary nonremunerated donors due to concerns regarding donation- and transfusion-transmitted infection as well as local and cultural beliefs. While increased awareness of HIV and improved testing techniques have jointly reduced infection-related apprehensions and improved the quality of available blood and blood products, continued efforts are warranted to bolster testing for other bloodborne pathogens. Similarly, although prevalence rates of anemia are high in some areas of the world, success in adequate widespread management of these conditions has been limited. One of the keys to expanding access to high-quality blood and blood products is thus to improve medical management of conditions that would otherwise require transfusion. Through a three-pronged approach to address quantity, quality, and demand, developing countries can enable themselves to build toward self-sufficient blood management services and increased independence from the support of international organizations.
虽然输血和血液制品的输注本能地与紧急护理的提供联系在一起，但血液和血液制品也经常用于亚急性和慢性疾病的治疗。尽管世界卫生组织和其他方面做出了努力，但在输血的获取和供应方面，发展中国家面临着三个方面的问题：供应不足、需求过大以及现有供应质量不佳。由于担心献血和输血传播感染以及当地文化信仰，发展中国家严重依赖替代献血者和有偿献血者，而非自愿无偿献血者。虽然对艾滋病毒的认识提高和检测技术的改进共同减少了与感染相关的担忧，并提高了现有血液和血液制品的质量，但仍需持续努力加强对其他血源性病原体的检测。同样，尽管世界某些地区贫血患病率很高，但在对这些病症进行充分广泛管理方面取得的成功有限。因此，扩大获得高质量血液和血液制品的机会的关键之一是改善对原本需要输血的病症的医疗管理。通过解决数量、质量和需求这三个方面的方法，发展中国家能够朝着建立自给自足的血液管理服务以及减少对国际组织支持的依赖的方向发展。
