Fraser J L, Whatmough A, Uhl L, Kruskall M S
Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
Transfusion. 1998 Sep;38(9):855-9. doi: 10.1046/j.1537-2995.1998.38998409006.x.
The standards of the American Association of Blood Banks describe a minimum hemoglobin level of 12.5 g per dL for apheresis donors. Until 1995, the authors' institution accepted occasional platelet donors with a lower minimum hemoglobin (11.5 g/dL), if accompanied by medical director approval.
All donation records from a 6-month period before 1995 were retrospectively reviewed to determine whether this lower hemoglobin cutoff adversely affected either the safety of the platelet donation process or donors' subsequent hemoglobin levels.
Of 450 donations, 56 (12%, Group 1) were from donors with hemoglobin concentrations between 11.5 and 12.4 g per dL (2 donations from 1 man; 54 donations from 45 women). The remaining 394 donations (88%, Group 2) came from donors with hemoglobin concentrations > or = 12.5 g per dL (216 donations from 118 men; 178 donations from 119 women). The frequency of donor reactions was acceptable (Group 1, 11%; Group 2, 6%); 2 percent of donations by Group 1 donors and 1 percent by Group 2 donors were terminated because of these reactions. Of 46 donors in Group 1, 30 returned to donate platelets again at a later time; at least once, 23 (77%) had a hemoglobin > or = 12.5 g per dL. Ten donors in Group 1 returned for additional donations within 56 days; no meaningful decrease in hemoglobin levels occurred. A hemoglobin cutoff of 12.5 g per dL during the study period would have excluded 1 percent of platelet donations by men and 23 percent by women.
The data demonstrate that the lower hemoglobin cutoff of 11.5 g per dL is a safe and relevant threshold for accepting female plateletpheresis donors and would allow more participation by women in blood donor programs.
美国血库协会的标准规定,单采献血者的最低血红蛋白水平为每分升12.5克。直到1995年,作者所在机构会偶尔接受最低血红蛋白水平较低(11.5克/分升)的血小板捐献者,但需医学主任批准。
对1995年前6个月的所有献血记录进行回顾性审查,以确定这种较低的血红蛋白临界值是否会对血小板捐献过程的安全性或捐献者随后的血红蛋白水平产生不利影响。
在450次捐献中,56次(12%,第1组)来自血红蛋白浓度在11.5至12.4克/分升之间的捐献者(1名男性的2次捐献;45名女性的54次捐献)。其余394次捐献(88%,第2组)来自血红蛋白浓度≥12.5克/分升的捐献者(118名男性的216次捐献;119名女性的178次捐献)。捐献者反应的发生率是可以接受的(第1组为11%;第2组为6%);第1组捐献者的2%和第2组捐献者的1%的捐献因这些反应而终止。在第1组的46名捐献者中,30名后来再次回来捐献血小板;至少有一次,23名(77%)的血红蛋白≥12.5克/分升。第1组的10名捐献者在56天内回来进行额外捐献;血红蛋白水平没有出现有意义地下降。在研究期间,每分升12.5克的血红蛋白临界值将排除1%男性的血小板捐献和23%女性的血小板捐献。
数据表明,每分升11.5克的较低血红蛋白临界值是接受女性单采血小板捐献者安全且合适的阈值,并且会让更多女性参与献血项目。