2007-10-10-世界卫生组织-Donor_selection_in_case_of_pandemic_situations_4页_15kb

WHO Blood Regulators Network (BRN) Summary: Donor Selection in Case of Pandemic Situations

Core Content

This document outlines the position of the WHO Blood Regulators Network (BRN) on donor selection during pandemic situations, particularly focusing on influenza pandemics. It emphasizes the need to balance blood supply security with the maintenance of quality and safety standards for blood components. The BRN recommends that regulatory authorities consider the implications of altering donor selection criteria and highlights the importance of maintaining essential procedures even during emergencies.

Main Views and Key Information

1. Alerting Blood Transfusion Services

• Blood transfusion services should be included in national pandemic plans.
• Information systems should be updated to reflect pandemic-related changes.

2. Scenario Development

• Countries should develop scenarios to estimate the impact of pandemics on donor availability and blood establishment personnel.
• These scenarios should consider:
  • The degree of donor and staff impact.
  • Strategies to mitigate the situation.
  • Critical transfusion needs.
• Blood use should be optimized and restricted to ensure availability.

3. Donor Eligibility Criteria

• General Principle: Standard procedures should remain unchanged unless there is extreme necessity.
• Exceptions:
  • Information to Donors: Donor information materials should be revised for clarity and donor acceptance, but not altered in content. Additional hygiene information and vaccination recommendations may be included.
  • Donor Identification and Selection: Information obtained from donors should remain unchanged.
  • Eligibility Changes: Any changes to donor screening for infectious parameters or deferral criteria should be limited to extreme necessity and clearly communicated to staff.
  • Less Restrictive Criteria:
    • Raise the upper age limit for donors, especially regular donors.
    • Lower haemoglobin levels for both females and males.
    • Shorten donation intervals for platelet apheresis, provided donor parameters remain within safe limits.
• Reporting Deadlines: Reporting requirements, except for severe adverse reactions, may be temporarily suspended during the pandemic period.

4. Quality and Safety Requirements

• In-Process Controls: Must be maintained to ensure regular production of blood components.
• Efficient Practices: Controls can be adapted to minimize waste, such as using sterile connecting devices.
• Deviations from Standards:
  • Allowable deviations must be pre-defined and justified.
  • For example, lowering withdrawal volume may affect citrate concentration, which must be monitored.
• Autologous Donations: May be considered for cancellation if staff resources are limited, due to their lower standardization and higher risk of errors.

5. Pandemic Influenza Specific Measures

• Re-entry Period: The time interval for donor re-entry after symptom cessation should be based on current scientific knowledge.
• Contact with Flu Patients: Donors with recent intensive contact with flu patients (e.g., sick-nursing) should be assessed by a qualified healthcare professional and may be accepted based on safety measures taken during contact.
• Post-Donation Flu Signs: Donors should be advised to report any flu-like symptoms following donation.
• Contagion Prevention: Donation dates should be scheduled to avoid gatherings. Masks and hand disinfection should be provided and encouraged.

Conclusion

The BRN underscores that while pandemic situations may necessitate adjustments to donor selection processes, such changes should be carefully evaluated and limited to exceptional circumstances. The priority remains ensuring the safety and quality of blood components, with only specific, well-justified modifications allowed. Communication with blood establishment staff and alignment with national health guidelines are critical to maintaining effective and safe blood donation practices during a crisis.