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首页> 外文期刊>Transfusion medicine >Evidence-based criteria for the care and selection of blood donors, with some comments on the relationship to blood supply, and emphasis on the management of donation-induced iron depletion.
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Evidence-based criteria for the care and selection of blood donors, with some comments on the relationship to blood supply, and emphasis on the management of donation-induced iron depletion.

机译：基于证据的护理和选择献血者的标准，其中有一些关于与血液供应的关系的评论，并强调了献血引起的铁耗竭的管理。

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Blood Services, which, in the UK, spend over 0.5% of the NHS budget, are generally subject to quality, regulatory, economic and political authority. As only persons in good health should give blood, Services have refined donor selection criteria and aim to base them on evidence; but they also have to balance the number of donations collected with product demand. Applying selection criteria inevitably leads to deferrals, which donors experience very negatively. Compared with successful donors, even temporary deferrals reduce return rates significantly, especially of first attenders. In order to encourage donor return and sustain supplies, selection criteria should be optimal. However, a major tool for managing patients - evidence from randomized controlled trials (RCTs) - cannot apply to donor selection, so criteria have to be defined by alternatives, such as clinical studies, epidemiology and even what experts deem to be pathophysiologically feasible. The recommended volume of blood taken from each donor at each attendance (450 mL, which was based on old studies) was increased because of greater processing losses (buffy-coat derived platelets, leucofiltration etc.). Although faint rates and donation-induced iron depletion are reduced by lowering bleeding volume and bleeding less frequently, other optimizing strategies including iron supplementation have been trialled and could be enhanced by more RCTs. Better but more complex indicators of donor iron status than one-off Hb thresholds are possible. Regulators and decision-makers must encourage more studies. This review does not consider aphaeresis donors of blood components other than red cells in detail, or the prevention of transfusion-transmitted infections.
机译：在英国，血液服务部门花费了国民健康服务预算的0.5％以上，通常要服从质量，法规，经济和政治权威。由于只有身体健康的人才能献血，服务处已完善了捐赠者的选择标准，并以证据为基础;但是他们还必须在募捐数量与产品需求之间取得平衡。应用选择标准不可避免地会导致延期，这会给捐赠者带来很大的负面影响。与成功的捐助者相比，即使是暂时的延期也大大降低了回报率，尤其是初次参加者。为了鼓励捐助者返回并维持供应，选择标准应该是最佳的。但是，管理患者的主要工具-随机对照试验（RCT）的证据-无法应用于捐赠者的选择，因此必须通过替代方法来定义标准，例如临床研究，流行病学，甚至专家认为在病理生理上可行的方法。由于更大的加工损失（血沉棕黄层衍生的血小板，白细胞滤过等），推荐的每次采血量（450毫升，基于古老的研究）有所增加。尽管通过减少出血量和减少出血频率减少了昏厥率和捐赠引起的铁耗竭，但已经尝试了其他优化策略，包括补充铁，可以通过更多的RCT来增强。比一次性血红蛋白阈值更好，更复杂的供体铁状态指标是可能的。监管者和决策者必须鼓励更多的研究。这篇综述没有详细考虑除红细胞以外的血液成分的无气供血者，也没有考虑预防输血传播的感染。

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