Analysis on blood scrapping of unqualified alanine transaminase from non-remunerated voluntary blood donors on streets in Dongying City of Shandong Province

Abstract

Objective To investigate the blood scrapping of unqualified alanine transaminase (ALT) from non-remunerated voluntary blood donors on the streets in Dongying City, Shandong Province, in order to control the ALT undetected error rate of street blood collection points effectively. Methods A total of 12 415 cases blood donors, who volunteered to participate in blood donation on the street in Dongying City from April 2016 to March 2018, were selected as subjects in this study. There were 6 897 cases blood donors who participated in blood donation from April 2016 to March 2017, and 5 518 cases blood donors who participated in blood donation from April 2017 to March 2018. The initial test of ALT in blood samples of blood donors were used dry biochemical method. And the retest of ALT were used kinetic method by automatic biochemical analyzer. According to the results of the initial test and retest of blood samples from blood donors, the initial undetected error rates and scrap rates of unqualified ALT were calculated. According to the distribution of ALT initial undetected error rates of 6 897 cases blood donors who participated in blood donation from April 2016 to March 2017, the rules of ALT initial undetected error was analyzed. And to investigate the effect of control the scrap rate of unqualified ALT of blood collection on the street from April 2017 to March 2018 by the rules of ALT initial undetected errors. Results ① In the study, among the 6 897cases blood donors who participated in blood donation from April 2016 to March 2017, the blood retest results of ALT value from 96 cases blood donors were >50 U/L. The total initial undetected error rate of ALT was 1.38%, and it meant the scrap rate of unqualified ALT was 1.38% too. The initial test results of ALT value in these 96 cases blood donors who undetected in initial test were distributed at the range of 42 U/L≤ALT value≤50 U/L, and mainly concentrated at 47 U/L≤ALT value≤50 U/L, accounting for 77.1%(74/96). For blood donors with the ALT initial test results which was <42 U/L, none of them undetected in the initial test and the undetected error rate was 0. In the 6 897 cases blood donors, the difference in the undetected error rates in different ALT initial test results range were statistically significant (χ2=50.64, P<0.001). And there was a downward trend in the composition ratios of donors in different ALT initial test results range from high to low (χ2trend=85.00, P<0.001). ② In these 5 518 cases blood donors who participated in the blood donation from April 2017 to March 2018, there were 330 cases blood donors whose ALT initial test results were in the range of 42 U/L≤ALT value≤50 U/L, among which 77 cases were found to be inconsistent between initial test and retest results, with the non-conformity rate of 23.3%. There were 5 188 cases blood donors whose ALT initial test results were <42 U/L. And the ALT retest results of these 5 188 cases blood donors were all ≤50 U/L, with the scrap rate of unqualified ALT of 0. Conclusions It can effectively control the unqualified ALT scrap rate at a street blood collection points while the ALT qualification value is set as ALT value<42 U/L. Since this conclusion is based only on the analysis of one single blood sampling point, it is still necessary to verify the conclusion through researches of multiple blood collection points and multiple regions. Key words: Alanine transaminase; Blood safety; Blood scrap; Blood scrap rate; Street blood collection