Lewin Antoine, Germain Marc, Renaud Christian, Robitaille Nancy, Latour Catherine
Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada.
Medical Affairs and Innovation, Héma-Québec, Québec, Québec, Canada.
Vox Sang. 2023 Dec;118(12):1041-1045. doi: 10.1111/vox.13523. Epub 2023 Sep 6.
Systematically measuring pre-donation haemoglobin (Hb) levels might be overly cautious for apheresis plasma donation, since plasmapheresis entails a small loss of red blood cells. We explored the association between the frequency of apheresis plasma donation and capillary blood Hb levels.
This retrospective cohort study included donors who gave apheresis plasma at least twice between 24 October 2020 and 23 October 2022 in Québec, Canada. Results were stratified by sex and analysed with linear repeated-measure mixed models with random intercepts.
In total, 9535 men (mean age = 46.7 years) and 9409 women (mean age = 41.1 years) made ≥2, but no more than 16 apheresis plasma donations. Over an average of 9.2 months of observation, men maintained Hb levels well above the Hb deferral threshold, and their Hb levels decreased by only 0.17 g/dL between the 1st and 15th donation return (p < 0.0001). Over an average of 9.0 months of observation, women also maintained adequate Hb levels, and their Hb levels decreased by 0.08 g/dL between the 1st and 15th donation return.
The frequency of apheresis plasma donation was not associated with clinically meaningful changes in Hb levels, neither in men nor in women. This evidence questions the relevance of systematically monitoring Hb for apheresis plasma donation, at least for donation frequencies of ≤7-8 times per year. However, an adverse impact of plasmapheresis on Hb levels cannot be ruled out for individuals donating more frequently or for longer than ~9 months.
对于单采血浆捐献而言，系统地检测捐献前血红蛋白（Hb）水平可能过于谨慎，因为血浆置换会导致少量红细胞流失。我们探讨了单采血浆捐献频率与毛细血管血Hb水平之间的关联。
这项回顾性队列研究纳入了2020年10月24日至2022年10月23日期间在加拿大魁北克至少进行过两次单采血浆捐献的捐献者。结果按性别分层，并采用具有随机截距的线性重复测量混合模型进行分析。
共有9535名男性（平均年龄 = 46.7岁）和9409名女性（平均年龄 = 41.1岁）进行了≥2次但不超过16次单采血浆捐献。在平均9.2个月的观察期内，男性的Hb水平维持在远高于Hb延期阈值的水平，其Hb水平在第1次和第15次捐献回访之间仅下降了0.17 g/dL（p < 0.0001）。在平均9.0个月的观察期内，女性也维持了足够的Hb水平，其Hb水平在第1次和第15次捐献回访之间下降了0.08 g/dL。
单采血浆捐献频率与男性和女性Hb水平的临床显著变化均无关联。这一证据对单采血浆捐献时系统监测Hb的相关性提出了质疑，至少对于每年≤7 - 8次的捐献频率是如此。然而，对于更频繁捐献或捐献时间超过约9个月的个体，不能排除血浆置换对Hb水平的不利影响。
