Diekamp U, Wehrend W, Marklof E, Kamutzky K
DRK-Blutspendedienst NSOB, Springe, Deutschland.
Beitr Infusionsther Transfusionsmed. 1996;33:81-92.
German authorities plan to legislate transfusion safety. We report on the efficacy of donor selection, unit pre-release testing, quality assurance and look-back efforts (LBE): Among 2,127,102 visits by 503,971 donors are 8.7% first-time donors. 96% of repeaters present our donor ID-card. We defer 5.6% repeat and 18.2% first-time donors, mostly for their own safety. 0.5% of the donors suffer a reaction. 94,000 units (4.7%) are not released due to confidential self-exclusion (1.1%), quality and safety concerns (1.7%), and positive screening tests (1.9%). Only 5.2% positive infectious disease screening tests were confirmed. HIV-prevalence of first-time donors is 0.002%; the HIV seroconversion rate for second-time donors is 0.003%. All other seroconversion rates for HBV, HCV, HIV and lues at subsequent donations are 0.001%. 23 donor-related LBE did not reveal a single HIV-infected recipient. In 106 recipient-related LBE involving 868 donors, we found 5 seroconverted donors (1 HBV, 3 HCV, 1 HIV).
Our repeat donors present proper ID. Strict donor selection criteria result in many rejections. Donor reactions are rare. High demands on blood safety and quality result in many discards. In our hands, confidential unit exclusion does not add safety. The HIV prevalence of first-time and repeat donors is equally low. Donor seroconversions are rare. LBE rarely identify infected donors or recipients. Our current high transfusion safety is unlikely to be improved through legislative measures.
德国当局计划制定输血安全方面的立法。我们报告了献血者选择、血液制品发放前检测、质量保证以及追溯措施（LBE）的效果：在503971名献血者的2127102次献血中，8.7%是首次献血者。96%的重复献血者出示了我们的献血者身份证。我们暂时推迟了5.6%的重复献血者和18.2%的首次献血者献血，主要是出于他们自身安全的考虑。0.5%的献血者出现了不良反应。94000单位血液制品（4.7%）因保密的自我排除（1.1%）、质量和安全问题（1.7%）以及筛查检测呈阳性（1.9%）而未被发放。仅5.2%的感染性疾病筛查检测呈阳性得到了确认。首次献血者的HIV感染率为0.002%；第二次献血者的HIV血清转化率为0.003%。后续献血时，所有其他HBV、HCV、HIV和梅毒的血清转化率均为0.001%。23次与献血者相关的追溯措施未发现一例受HIV感染的受血者。在涉及868名献血者的106次与受血者相关的追溯措施中，我们发现了5名血清转化的献血者（1例HBV、3例HCV、1例HIV）。
我们的重复献血者出示了有效的身份证件。严格的献血者选择标准导致许多人被拒绝献血。献血者不良反应很少见。对血液安全和质量的高要求导致许多血液制品被丢弃。在我们这里，保密的血液制品排除措施并未增加安全性。首次和重复献血者的HIV感染率同样很低。献血者血清转化很少见。追溯措施很少能识别出受感染的献血者或受血者。我们目前较高的输血安全性不太可能通过立法措施得到改善。
