McClelland D B, McMenamin J J, Moores H M, Barbara J A
Edinburgh South East Scotland Blood Transfusion Service, UK.
Transfus Med. 1996 Mar;6(1):1-10. doi: 10.1046/j.1365-3148.1996.d01-47.x.
The last decade has seen substantial improvements in the provision of safe "infection-free' blood for patients in many countries. This has resulted from the combined effects of better donor education, selection, testing and exclusion processes. The residual risk of infection with HBsAg attributable to laboratory error is less than 0.1/ 100,000 (1/750,000). The risk for HIV remains to be quantified but may approach this figure. With such low risks it will be difficult to provide statistical evidence that further improvements in the process of selection, testing or exclusion will have an impact on reducing risk from either agent. Over the same time, less progress has been made reducing risk to the recipient attributable to problems in the clinical supply process, i.e. getting the right blood, to the right person, at the right place, at the right time. Uniform definitions of terminology defining blood donation characteristics, together with the sharing of performance data are essential if we are to make national and international comparison of the risks that patients face when they receive a transfusion. Equally, the use of agreed definitions, and the sharing of data on the clinical outcomes of transfusion can provide the key to better prescribing based on evidence of actual risks and benefits.
在过去十年中，许多国家为患者提供安全“无感染”血液的工作取得了显著进展。这是更好的献血者教育、筛选、检测和排除流程共同作用的结果。因实验室误差导致感染乙肝表面抗原（HBsAg）的残余风险低于十万分之一（七十五万分之一）。艾滋病毒（HIV）的风险尚待量化，但可能接近这一数字。由于风险如此之低，很难提供统计证据证明在筛选、检测或排除流程上的进一步改进会对降低这两种病原体带来的风险产生影响。与此同时，在降低临床供血过程中（即在正确的时间、将正确的血液送到正确的地点、给正确的人）出现的问题给受血者带来的风险方面，进展较小。如果我们要对患者输血时面临的风险进行国内和国际比较，统一界定献血特征的术语定义以及共享绩效数据至关重要。同样，使用商定的定义并共享输血临床结果的数据，可以为基于实际风险和益处的证据进行更好的输血处方提供关键依据。
