Blutspende nach Maß: Konzept für zeitgemäßes Blutspendewesen

Abstract

‘Product-oriented Blood Donation’ is a concept of ‘heme economies’. It takes advantage of recent developments in preparation and storage of blood components at a time, when new therapeutic concepts, safety and cost concerns may dramatically reduce the need for allogeneic blood products in transfusion medicine. The concept facilitates substantial savings within the health care system. Simply, red cell and platelet concentrates for allogeneic transfusion therapy are prepared only from group 0 whole blood donated by volunteer non-remunerated donors. Suspending these plasma- and leukocyte-depleted blood cell preparations in the appropriate additive nutrient solutions renders them universally ABO-com-patible. Similarly, universally ABO-compatible fresh-frozen plasma for allogeneic transfusion is to be procured exclusively from group AB donors by plasmapheresis. Volunteer donors of all blood groups may qualify for donating HLA-compatible platelets by apheresis, as needed. The plasma derived from the group 0 blood donations will supply more than 50% of the source plasma needed for fractionation. The remainder may stem from first-time donors (blood group yet unknown), from AB apheresis plasma not qualifying for release because of no return of donor for retesting after quarantine storage, and from plasmapheresis of donors with blood groups A or B. In Germany, the current level of group 0 and AB donations is sufficient to supply the preparations needed for allogeneic transfusion. Approximately 50 plasmapheresis facilities will be operating soon. At this time, the German requirement of ABO-iden-tical allogeneic transfusion appears to be the greatest impediment for the concept of ‘Product-oriented Blood Donation’.