互助无偿献血政策取消对广州市无偿献血情势的影响

The impact of ceasing mutual blood donation on voluntary blood donation in Guangzhou

目的了解广州市全面取消互助献血政策对该市无偿献血的影响。方法1)在广州血液中心采供血管理系统中收集2016年7月~2019年12月(广州市正式取消互助献血政策日前后42个月)的无偿献(采)血数据,包括献全血和献血小板人次,按"月"做间断时间序列分析;2)随访在2016年1月1日~2016年12月31日献过血[包括全血和成分血(单采血小板)]的献血者至2019年12月31日,使用卡方检验、独立样本t检验、Logistic回归等方法分析其再次献血情况。结果间断时间序列分析:取消互助献血的政策对献全血没有明显影响,但对献机采血小板的人次提升有明显的正面效应;2016年全血和血小板献血人次均以自愿献血为主(86.4%和60.8%);互助献血的血液检验不合格率(双试剂)总体比自愿献血高(P<0.01),但是对于献血≥2次者不合格率来说两者之间并没有明显变化(P>0.05);无论是互助献血者、自愿献血者或者是混合献血者,在取消互助献血后的再次献血率均比取消互助献血前高(互助:4.7%vs 4.0%,自愿:24.8%vs 9.9%,混合:36.3%vs 28.1%,P<0.01);互助献机采血小板者在取消互助献血后再次献血率有所降低,但自愿献机采血小板者却有所提升。结论取消互助献血对广州市无偿献血情势没有发生负面影响,相反由于此前本中心为建设自愿无偿献血长效机制采取的各种措施显效,无偿献血人次有所升,临床用血得到了进一步的保障。

Objective To investigate the impact of ceasing mutual blood donation on voluntary blood donation in Guangzhou.Methods The data of blood donation from July 2016 to December 2019(42-month before and after the official cease of mutual blood donation)in the Blood Collection and Supply System of Guangzhou Blood Center,including whole blood donations and apheresis platelets donations,were collected for interrupted time series analysis by month.Blood donors who donated(either whole blood or platelets)during 2016 were followed up until December 31,2019,and the re-donation rate was analyzed by Chi-square test,t test and logistic regression analysis.Results The results showed that ceasing mutual blood donation had a significantly positive effect on the increase of platelet donations,but had no significant effect on whole blood donation.In 2016,whole blood donations and platelet donations were mainly voluntary(86.4%and 60.8%,respectively).In comparison of voluntary blood donation,the overall blood deferral rate(by dual assays)of mutual blood donation was higher(P<0.01),but the difference diminished as they donated twice or more.The re-donation rate of blood donors(mutual non-remunerated,voluntary,or both)all increased after the ceasing of mutual blood donation(mutual non-remunerated,:4.7%vs 4.0%,χ;=29.8,P<0.01;voluntary:24.8%vs 9.9%,χ;=17295.3,P<0.01;both:36.3%vs 28.1%,χ;=29.3,P<0.01).The re-donation rate of mutual platelet donors decreased after the ceasing of mutual blood donation,but the number of voluntary platelet donors increased.Conclusion The ceasing of mutual blood donation was in favour of voluntary blood donation in Guangzhou since various means had been previously adopted by Guangzhou Blood Center to create a long-term mechanism of voluntary blood donation.The number of voluntary blood donors has increased,and the clinical use of blood has been further guaranteed.