Brunson Dalton C, Belanger Geoffrey A, Sussmann Harry, Fine Andrew M, Pandey Suchitra, Pham Tho D
Stanford School of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Stanford Blood Center, Palo Alto, California, USA.
Transfusion. 2022 Jun;62(6):1269-1279. doi: 10.1111/trf.16893. Epub 2022 May 5.
Blood centers have a dual mission to protect donors and patients; donor safety is paramount to maintaining an adequate blood supply. Elucidating donor factors associated with adverse reactions (AR) is critical to this mission.
STUDY DESIGN/METHODS: A retrospective cohort analysis of whole blood donors from 2003 to 2020 was conducted at a single blood center in northern California. Adjusted odds ratios (AORs) with 95% CIs for ARs were estimated via multivariable logistic regression on demographics, donation history, and physical examination data. Where appropriate, Wilcoxon-Rank Sum and chi-squared tests were used to determine significance.
First-time blood donors (FTD) exhibited a higher AR rate than repeat donors (4.4% vs. 1.9% p < .0001). When compared with FTDs without AR, FTDs with ARs (FT-AR) were less likely to return (30.0% vs. 47.3%, p < .0001), and, of those who returned, had a higher rate of reaction 20.2% versus 2.8% (p < .001). Factors found to be associated with FT-AR (younger age, increased heart rate, and higher diastolic blood pressure) still correlated positively with AR on return donation, but to a lower degree. FTD who potentially witnessed an AR had a lower return rate (44.6% vs. 47.3%, p = <.001) and donated fewer units (2.38 vs. 3.37, p < .001) when compared to FTD who did not witness an AR.
The AR on FTD increases the AR likelihood of return donation. Longitudinal analysis shows that a time-based deferral policy targeted at FT-AR young donors can reduce the number of ARs while not dramatically impacting the blood supply.
血液中心肩负着保护献血者和患者的双重使命；献血者安全对于维持充足的血液供应至关重要。阐明与不良反应（AR）相关的献血者因素对这一使命至关重要。
研究设计/方法：对2003年至2020年期间加利福尼亚北部一家单一血液中心的全血献血者进行回顾性队列分析。通过对人口统计学、献血历史和体格检查数据进行多变量逻辑回归，估计AR的调整优势比（AOR）及95%置信区间。在适当情况下，使用Wilcoxon秩和检验和卡方检验来确定显著性。
首次献血者（FTD）的AR发生率高于重复献血者（4.4%对1.9%，p <.0001）。与无AR的FTD相比，有AR的FTD（FT-AR）再次献血的可能性较小（30.0%对47.3%，p <.0001），并且在再次献血的人中，反应发生率更高（20.2%对2.8%，p <.001）。发现与FT-AR相关的因素（年龄较小、心率加快和舒张压较高）在再次献血时与AR仍呈正相关，但程度较低。与未目睹AR的FTD相比，可能目睹AR的FTD再次献血率较低（44.6%对47.3%，p =<.001）且献血单位数较少（2.38对3.37，p <.001）。
FTD的AR增加了再次献血时发生AR的可能性。纵向分析表明，针对FT-AR年轻献血者的基于时间的延期政策可以减少AR的数量，同时不会对血液供应产生重大影响。
