Causes and characteristics analysis of deferred blood donation in apheresis platelet donors
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摘要: 目的 通过分析近年来单采血小板献血者延迟献血的主要原因及特征，为提高献血合格率、降低采血成本提供参考。方法 收集2019年7月—2023年6月在中心血站捐献单采血小板的献血者信息，比较不同年份间体检征询不合格率、血液初筛不合格率以及各分项目的不合格分布情况，同时比较初次和重复捐献者间、不同性别间、18~55岁和56~60岁单采血小板献血者间的体检初筛情况等差异。结果 2019年7月—2023年6月共4年间，台州地区单采血小板共计登记24 202人次，总体延迟献血3 142人次(13.0%)，其中因体检征询不合格871人次(3.6%)，血液初筛不合格原因2 271人次(9.4%)。近年的延迟献血率和初筛不合格率均处于相对平稳状态。血液初筛不合格主要为丙氨酸氨基转移酶(ALT)、白细胞计数(WBC)和乳糜血项目，分别占初筛总人次的2.8%、2.4%和1.8%。初次献血者(20.3%)献血延迟率较重复献血者(12.4%)高(P < 0.001), 女性(19.6%)较男性(11.4%)高(P < 0.001)，18~55岁单采血小板献血者(13.2%)较56~60岁高龄者(8.9%)高(P < 0.001)。结论 台州地区近年来单采血小板献血者延迟献血的主要原因是血液初筛不合格，其中以ALT、WBC和乳糜血居多。重复献血者、男性及56~60岁高龄单采血小板献血者的献血延迟率较低。要根据本地区特征加强献血者精细化管理，提供个体化管理建议，从而降低献血延迟率，降低采血成本，保留献血者。Abstract: Objective To analyze the main causes and characteristics of deferred blood donation in apheresis platelet donors in recent years, and provide a reference for improving the qualified rate of blood donation and reduce the cost.Methods The information of blood donors who donated apheresis platelets in center blood stations from July 2019 to June 2023 was collected, and the failure rate of physical examination consultation, the failure rate of initial blood screening and the failure distribution of each sub-item in different years were compared. The differences of initial screening between primary and repeat donors, between different genders, between 18-55 years old and 56-60 years old apheresis platelet donors were compared.Results During the four years from July 2019 to June 2023, a total of 24 202 platelet donation cases were registered in Taizhou, and 3 142 blood donation cases(13.0%) were delayed, among which 871 cases(3.6%) failed to pass physical examination consultation and 2 271 cases(9.4%) failed to pass primary blood screening. The delayed blood donation rate and the unqualified rate of initial screening were in a relatively stable state in recent years. The main unqualified items in the primary screening were alanine aminotransferase(ALT), white blood cell count(WBC) and chylous blood, accounting for 2.8%, 2.4% and 1.8% of the total number of primary screening patients, respectively. The delayed blood donation rate was higher in first-time donors(20.3%) than in repeat donors(12.4%)(P < 0.001), in females(19.6%) than in males(11.4%)(P < 0.001), and in 18-55 year old monocollection platelet donors(13.2%) than in 56-60 year old patients(8.9%)(P < 0.001).Conclusion The main reasons for blood donation deferral of apheresis platelet donors in Taizhou area these years were unqualified blood screening, among which ALT, WBC and chylous blood were in the majority. Repeat donors, males and elderly donors aged 56-60 years old had a lower blood donation deferral. It is necessary to strengthen the refined management of blood donors according to the characteristics of this area and provide individualized management suggestions, so as to reduce the delay rate of blood donation, reduce the cost of blood collection and retain blood donors.
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表 1 2019.7.1—2023.6.30单采血小板初筛情况
时间 登记总人次 体检征询不合格/例(%) 血液初筛不合格/例(%) 成功采集/例(%) 2019.7.1—2020.6.30 5 840 204(3.5) 580(9.9) 4 978(85.2) 2020.7.1—2021.6.30 5 856 208(3.6) 501(8.6) 5 088(86.9) 2021.7.1—2022.6.30 5 875 220(3.7) 426(7.3) 5 170(88.0) 2022.7.1—2023.6.30 6 631 239(3.6) 764(11.5) 5 618(84.7) 合计 24 202 871(3.6) 2 271(9.4) 20 854(86.2) 注：有一部分人群初筛合格而未成功采集血液，包括献血者个人原因及采集过程异常原因。 
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表 2 2019.7.1—2023.6.30单采血小板献血者血液初筛检测不合格项目分布
时间 初筛总人次 不合格项目/例(%) 合计 ALT Hb HCT PLT WBC 乳糜血 HBsAg TP 2019.7.1—2020.6.30 5 636 580(10.3) 141(2.5) 34(0.6) 102(1.8) 67(1.2) 126(2.2) 112(2.0) 3(0.1) 0 2020.7.1—2021.6.30 5 648 501(8.9) 80(1.4) 38(0.7) 87(1.5) 47(0.8) 150(2.7) 98(1.7) 4(< 0.1) 1(< 0.1) 2021.7.1—2022.6.30 5 655 426(7.5) 88(1.6) 39(0.7) 47(0.8) 44(0.8) 129(2.3) 82(1.5) 1(< 0.1) 1(< 0.1) 2022.7.1—2023.6.30 6 392 764(12.0) 351(5.5) 64(1.0) 93(1.5) 47(0.7) 152(2.4) 130(2.0) 5(0.1) 2(< 0.1) 合计 23 331 2 271(9.7) 660(2.8) 175(0.8) 329(1.4) 205(0.9) 557(2.4) 422(1.8) 13(0.1) 4(< 0.1)
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