Donor Medicine, Sanquin Blood Bank, Amsterdam, the Netherlands.
Transfusion. 2024 May;64(5):854-865. doi: 10.1111/trf.17759. Epub 2024 Feb 22.
Many blood banks use upper age limits for donors out of concern for a higher donor complication rate in older donors. Experienced donors are known to have lower donor complication rates, and older donors are often more experienced, confounding the effect of age on donor complication rate.
We studied donor complication rates in whole blood, plasma, and plateletpheresis donors from 2012 to 2022. Donor complication rates were compared between age groups in inexperienced (<20th donation) and experienced (≥20th donation) donors. In addition to this direct comparison, we made use of logistic regression with finer-grained experience groups, to further quantify the effects of age, experience and other factors on donor complication rate.
While overall rate of vasovagal reaction was lower, rate of moderate/severe vasovagal syncope was highest in 70-79 year donors, however, only reached significance for plasma donors. Furthermore, rates of failed stab were highest in this age group. Hematoma rate showed a U-shaped pattern with regard to age, where the rate was not higher in the 70-79 year age group than in the 18-23 year age group. Pain decreased with age, however, rates were higher in the 70-79 year age group than in the 65-69 year age group.
When properly accounting for donor experience, donor complication rate profiles clearly change with age. The increased risk for moderate/severe vasovagal syncope in older donors should be clearly communicated. Extra caution is needed if these donors are accepted for first-time donations.
许多血库出于对老年献血者更高的献血者并发症发生率的担忧,对献血者设定了年龄上限。经验丰富的献血者已知具有较低的献血者并发症发生率,而且老年献血者通常更有经验,这使得年龄对献血者并发症发生率的影响变得复杂。
我们研究了 2012 年至 2022 年间全血、血浆和血小板单采献血者的献血者并发症发生率。在无经验(<20 次献血)和有经验(≥20 次献血)献血者中,比较了不同年龄组的献血者并发症发生率。除了这种直接比较之外,我们还使用了更精细的经验分组逻辑回归,以进一步量化年龄、经验和其他因素对献血者并发症发生率的影响。
虽然总体血管迷走神经性反应发生率较低,但 70-79 岁献血者中度/重度血管迷走神经性晕厥的发生率最高,但仅在血浆献血者中达到显著水平。此外,该年龄组的采血失败率最高。血肿发生率与年龄呈 U 形模式,70-79 岁年龄组的发生率并不高于 18-23 岁年龄组。疼痛随年龄的增长而减轻,但 70-79 岁年龄组的疼痛发生率高于 65-69 岁年龄组。
当适当地考虑到献血者的经验时,献血者并发症发生率的分布随着年龄的变化而明显改变。应明确告知老年献血者发生中度/重度血管迷走神经性晕厥的风险增加。如果这些献血者被接受进行首次献血,则需要格外小心。