Challenges in the management of the blood supply
Challenges in the management of the blood supply
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DOI：
10.1016/s0140-6736(13)60631-5
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发表时间：
2013-05-25
期刊：
影响因子：
168.9
通讯作者：
Devine, Dana V.
中科院分区：
文献类型：
--
作者：
Williamson, Lorna M.;Devine, Dana V.
尽管由于采取了患者血液管理措施，血液供应商的血液需求在短期内有所减少，但模型表明，在未来5-10年内，发达国家的血液供应将需要再次增加，以满足老龄化人口的需求。血液供应的增加带来了许多挑战;将需要新的方法来招募和留住未来几代献血者，并且需要注意避免从这些献血者身上抽取过多的血液。输血服务和医院之间的血液库存管理的综合方法对于最大限度地减少浪费非常重要，例如，通过使用行业的供应链解决方案。需要开发用于患者血液管理的跨学科系统，以减少输血的需要，例如，通过早期识别和使用造血药逆转贫血或逆转根本原因。个性化医疗可以应用于匹配捐赠者和患者，不仅通过扩展血型，而且通过使用血液成分的基因决定的储存特性。从干细胞中大量生长红细胞或血小板在未来是一种可能性，但成本，规模和可重复性的挑战仍有待解决。
Although blood suppliers are seeing short-term reductions in blood demand as a result of initiatives in patient blood management, modelling suggests that during the next 5-10 years, blood availability in developed countries will need to increase again to meet the demands of ageing populations. Increasing of the blood supply raises many challenges; new approaches to recruitment and retainment of future generations of blood donors will be needed, and care will be necessary to avoid taking too much blood from these donors. Integrated approaches in blood stock management between transfusion services and hospitals will be important to minimise wastage-eg, by use of supply chain solutions from industry. Cross-disciplinary systems for patient blood management need to be developed to lessen the need for transfusion-eg, by early identification and reversal of anaemia with haematinics or by reversal of the underlying cause. Personalised medicine could be applied to match donors to patients, not only with extended blood typing, but also by using genetically determined storage characteristics of blood components. Growing of red cells or platelets in large quantities from stem cells is a possibility in the future, but challenges of cost, scaling up, and reproducibility remain to be solved.