Strauss R G, Ludwig G A, Smith M V, Villhauer P J, Randels M J, Smith-Floss A, Koerner T A
DeGowin Blood Center, University of Iowa Hospitals and Clinics, University of Iowa College of Medicine, Iowa City.
Transfusion. 1994 Feb;34(2):116-21. doi: 10.1046/j.1537-2995.1994.34294143937.x.
Historically, paid blood donors were found to transmit hepatitis at higher rates than volunteers. In those older studies, paid donors frequently were recruited from prisons or slum areas--a finding consistent with the belief that monetary payment in itself did not necessarily lead to the high-risk status of commercial blood. Instead, it was the population base from which the donors were recruited that was important.
Today, cytapheresis donors are in great demand. Because payment is one incentive that might entice donors to undertake the increased commitment of repeated cytapheresis donation, the results were studied of infectious disease history and laboratory testing performed concurrently in 917 volunteer whole-blood donors and 1240 paid cytapheresis donors, who were enrolled in distinct programs at the DeGowin Blood Center from October 7, 1987, through November 30, 1990.
When first, repeat, and overall donations made by these donors were evaluated separately, paid cytapheresis donors were found to exhibit no increase in infectious disease history or test results beyond those of volunteer whole-blood donors.
Thus, paid cytapheresis donors, when managed within a formal program, should not necessarily be presumed to be more dangerous than volunteers, from an infectious disease aspect. However, definitive proof of safety (comparison of transfusion-transmitted infection rates in two groups of patients receiving blood components exclusively from either paid cytapheresis or volunteer donors) was not pursued by long-term follow-up studies.
从历史上看,有偿献血者传播肝炎的比率高于无偿献血者。在那些早期研究中,有偿献血者常常从监狱或贫民窟招募——这一发现与金钱报酬本身不一定导致商业血液处于高风险状态的观点一致。相反,献血者招募的人群基础才是重要的。
如今,血细胞分离术献血者的需求很大。由于报酬是一种可能吸引献血者增加重复进行血细胞分离术献血的诱因,因此对1987年10月7日至1990年11月30日期间在德高因血液中心分别参加不同项目的917名无偿全血献血者和1240名有偿血细胞分离术献血者的传染病史和同时进行的实验室检测结果进行了研究。
当分别评估这些献血者的首次、重复及总体献血情况时,发现有偿血细胞分离术献血者的传染病史或检测结果与无偿全血献血者相比并无增加。
因此,从传染病角度来看,有偿血细胞分离术献血者在正规项目管理下,不一定比无偿献血者更具危险性。然而,长期随访研究并未对安全性进行确切证明(比较两组仅接受来自有偿血细胞分离术献血者或无偿献血者血液成分的患者的输血传播感染率)。