Payne Madeleine, Gorsky Martin, Sutherland Colin J, Shanks G Dennis
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia.
Am J Trop Med Hyg. 2025 Jan 14;112(4):793-796. doi: 10.4269/ajtmh.24-0625. Print 2025 Apr 2.
Allied prisoners of war (POWs) working on the Imperial Japanese Army's railroad from Thailand to Burma during 1943-1945 devised a blood transfusion service to rescue severely ill fellow prisoners who were otherwise unlikely to survive the war. Extant transfusion records (1,251 recipients, 1,189 donors) in ledger books held by the United Kingdom National Archives at Kew were accessed and analyzed. Survival to the end of the war in 1945 was determined from Commonwealth War Graves Commission records. The records examined indicate that freshly donated whole blood was manually defibrinated and transfused after crossmatches based on POW medic sera. Overall survival to the end of the war was 74% in recipients and 88% in donors. Postwar survival rates were significantly higher for transfusion recipients with malaria (89.3%) than for other diagnoses: 52.6% for malnutrition, 59.3% for dysentery, 67.2% for skin ulcers, and 75.4% for other causes (odds ratio: 3.97; 95% CI: 2.79-5.28; P <0.0001). By 1945, the vast majority of blood transfusions were given for severe anemia caused by chronic relapsing vivax malaria. Although the POW situation was admittedly extreme, our data provide evidence that blood transfusions to treat severe anemia were associated with higher survival among patients with Plasmodium vivax infection than among those with other morbidities.
1943年至1945年期间，在日本帝国陆军从泰国到缅甸的铁路上工作的盟军战俘设计了一种输血服务，以拯救病重的 fellow prisoners，否则他们很可能无法在战争中存活下来。查阅并分析了英国国家档案馆（位于基尤）保存的账本中的现有输血记录（1251名受血者，1189名献血者）。根据英联邦战争墓地委员会的记录确定了1945年战争结束时的存活情况。所检查的记录表明，新鲜捐献的全血经过人工去纤维蛋白处理，并在根据战俘军医血清进行交叉配血后进行输血。受血者的总体战争结束时存活率为74%，献血者为88%。疟疾输血受血者的战后存活率（89.3%）显著高于其他诊断情况：营养不良为52.6%，痢疾为59.3%，皮肤溃疡为67.2%，其他原因导致的为75.4%（优势比：3.97；95%置信区间：2.79 - 5.28；P <0.0001）。到1945年，绝大多数输血是用于治疗由慢性复发性间日疟引起的严重贫血。尽管战俘的情况无疑很极端，但我们的数据提供了证据，即治疗严重贫血的输血与间日疟原虫感染患者的较高存活率相关，高于其他疾病患者。
