献血者铁缺乏:现状与管理

随着全球无偿献血的发展,人们对献血者铁缺乏风险的认识也在不断提高。目前已知献血的唯一明显缺点就是潜在的铁缺乏风险。因此,预防献血者铁缺乏的发生十分必要。近20年内,在输血医学伦理规范的大背景下,遵循对献血者的尊重和无伤害原则,促成了基于国家和地区层面针对献血者铁代谢管理实施干预的发展。近10年美国血库联合会(AABB)实施了多项大规模针对性研究;加拿大前后经历了5年多的系统研究也发现献血者尤其是女性献血者和频繁献血者铁缺乏是很常见的;欧盟2020年5月发布的最新法规明确血液机构必须有适当的措施,以尽量减少频繁献血者的铁消耗。我国自上世纪80年代末,也有专业人士开始针对献血者铁代谢的研究,但至今缺乏针对献血者铁管理的大样本量研究实践。本专题展示了北京地区献血者铁代谢现状大规模调查的研究成果,希望为全国同行实施献血者铁管理的干预措施,提供基础性数据和决策支持。

Blood donor iron deficiency: status and management

Objective With the development of global voluntary blood donation, people′s awareness of the risk of blood donor iron deficiency is also increasing. The only significant shortcoming of the blood donation currently known is the potential risk of iron deficiency. Therefore, it is necessary to prevent the occurrence of iron deficiency in blood donors. In the past two decades, in the context of the ethics of blood transfusion medicine, following the principles of respecting and non-harmfulness to blood donors has led to the development of interventions on blood donor iron metabolism management based on national and regional levels. In the past decade, the American Association of Blood Banks(AABB) had carried out a number of large-scale targeted studies. A systematic study in Canada, covering a period of more than 5 years, also found that iron deficiency in blood donors, especially female blood donors and frequent blood donors, was very common. The latest EU regulations issued in May 2020 make it clear that blood banks must implement appropriate measures to minimize the iron consumption of frequent blood donors. Since the late 1980 s in my country, some professionals have begun to study the iron metabolism of blood donors, but so far there is a lack of large-scale research for blood donor iron management. This topic presents the research results of a large-scale survey on the status of iron metabolism of blood donors in Beijing, hoping to provide basic data and decision support for the implementation of iron management interventions for blood donor across the country.