Transfusion Clinique et Biologique最新文献

Hyperbilirubinemia in neonates with blood group incompatibilities − A bane or a boon for the management 高胆红素血症与血型不合的新生儿-管理的祸福。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2025.01.004

Smita Mahapatra , Kaushik Patra , Swarupa Panda , Sasmita Behuria , Pratima Kumari Sahu , Madan Mohan Majhi

Objectives

Neonatal hyperbilirubinemia, or newborn jaundice, is a common condition caused by high bilirubin levels. Blood group incompatibility between mother and baby is a major cause. This study examined the link between different blood group incompatibilities and their management in newborns with jaundice.

Material & Methods

This prospective observational study included 190 neonates with hyperbilirubinemia requiring phototherapy. They were divided into two groups: control (blood group compatible) and case (blood group incompatible). Data on demographics, investigations, and management were collected.

Results

Blood group incompatibility was present in 36.3% of cases, primarily ABO (28.9%). Rh incompatibility and ABO + Rh incompatibility accounted for 5.3% and 1.6%, respectively. DAT was positive in 32.7% of ABO incompatible cases, with anti-B more prevalent. Neonates with ABO incompatibility had the highest mean total serum bilirubin (TSB) level (13.04 mg/dL) and the largest overall decrease in TSB (–33.77%).The mean phototherapy duration was significantly longer in cases (44.1 h) compared to controls (35.5 h). ABO incompatible neonates had a longer average phototherapy duration (42.32 h) compared to controls. However, ABO+Rh and pure Rh incompatible cases had highest phototherapy duration among cases. Moreover, within ABO cases, the mean phototherapy duration was higher in DAT-positive cases (46 h) compared to DAT-negative cases (40.2 h). Delivery mode, parity, and gender did not significantly influence phototherapy duration, but gestational age might play a role.

Conclusion

Various blood group incompatibilities, beyond RhD, are significantly associated with hyperbilirubinemia requiring phototherapy. ABO incompatibility was the most common cause. Neonatal jaundice is linked to blood group mismatch, with ABO+Rh and pure Rh incompatibility requiring longer phototherapy. However, ABO incompatible cases had longer phototherapy in comparison to controls. Gestational age might influence phototherapy duration.

目的：新生儿高胆红素血症或新生儿黄疸是由高胆红素水平引起的一种常见疾病。母亲和婴儿血型不合是主要原因。本研究探讨了新生儿黄疸不同血型不相容及其管理之间的联系。材料与方法：本前瞻性观察研究纳入190例需要光疗的高胆红素血症新生儿。患者分为对照组（血型相容组）和病例组（血型不相容组）。收集了人口统计、调查和管理方面的数据。结果：36.3%的病例存在血型不合，以ABO血型为主（28.9%）。Rh不相容和ABO+Rh不相容分别占5.3%和1.6%。32.7%的ABO血型不匹配病例DAT阳性，其中抗b更为普遍。ABO血型不相容新生儿的平均血清总胆红素（TSB）水平最高（13.04 mg/dL）， TSB总体下降幅度最大（-33.77%）。与对照组（35.5小时）相比，病例的平均光疗时间（44.1小时）明显更长。ABO血型不相容的新生儿与对照组相比，平均光疗时间更长（42.32小时）。而ABO+Rh和纯Rh不相容的患者光疗时间最长。此外，在ABO病例中，dat阳性病例的平均光疗时间（46小时）高于dat阴性病例（40.2小时）。分娩方式、胎次和性别对光疗持续时间没有显著影响，但胎龄可能起作用。结论：除RhD外，各种血型不相容与需要光疗的高胆红素血症显著相关。ABO血型不合是最常见的原因。新生儿黄疸与血型不匹配有关，ABO+Rh和纯Rh不相容需要更长时间的光疗。然而，与对照组相比，ABO不相容病例的光疗时间更长。胎龄可能影响光疗持续时间。

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引用次数: 0

A false alarm of hemolytic transfusion reaction 溶血性输血反应的假警报。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2025.01.001

Priyadarsini Jayachandran Arcot, Karan Kumar, Amin Mir

引用次数: 0

Assessment of machine learning classifiers for predicting intraoperative blood transfusion in non-cardiac surgery 评估预测非心脏手术术中输血的机器学习分类器。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2024.10.006

Insun Park , Jae Hyon Park , Jongjin Yoon , Chang-Hoon Koo , Ah-Young Oh , Jin-Hee Kim , Jung-Hee Ryu

Background

This study aimed to develop a machine learning classifier for predicting intraoperative blood transfusion in non-cardiac surgeries.

Methods

Preoperative data from 6255 patients were extracted from the VitalDB database, an open-source registry. The primary outcome was the area under the receiver operating characteristic (AUROC) curve of ML classifiers in predicting intraoperative blood transfusion, defined as the receipt of at least one unit of packed red blood cells. Five different machine learning algorithms including logistic regression, random forest, adaptive boosting, gradient boosting, and the extremely gradient boosting classifiers were used to construct a binary classifier for intraoperative blood transfusion, and their predictive abilities were compared.

Results

337 (5%) patients received intraoperative blood transfusion. In the test-set, the logistic regression classifier demonstrated the highest AUROC (0.836, 95% CI, 0.795–0.876), followed by the gradient boosting classifier (0.810, 95% CI, 0.750–0.868), AdaBoost classifier (0.776, 95% CI, 0.722–0.829), random forest classifier (0.735, 95% CI, 0.698–0.771), and XGBoost classifier (0.721, 95% CI, 0.695–0.747). The logistic regression classifier showed a higher AUROC compared to that of a multivariable logistic regression model (0.836 vs. 0.623, P < 0.001). Among various parameters used to construct the logistic regression classifier, the top three most important features were operation time (0.999), preoperative serum hemoglobin level (0.785), and open surgery (0.530).

Conclusion

We successfully developed various ML classifiers using readily available preoperative data to predict intraoperative transfusion in patients undergoing non-cardiac surgeries. In particular, the logistic regression classifier demonstrated the best performance in predicting intraoperative transfusion.

背景：本研究旨在开发一种用于预测非心脏手术术中输血的机器学习分类器：本研究旨在开发一种用于预测非心脏手术术中输血的机器学习分类器：从开源注册数据库 VitalDB 数据库中提取了 6255 名患者的术前数据。主要结果是机器学习分类器预测术中输血的接收者操作特征曲线下面积（AUROC），术中输血定义为接受至少一个单位的包装红细胞。我们使用了五种不同的机器学习算法，包括逻辑回归、随机森林、自适应提升、梯度提升和极梯度提升分类器，构建了术中输血的二元分类器，并比较了它们的预测能力：结果：337 例（5%）患者接受了术中输血。在测试集中，逻辑回归分类器的 AUROC 最高（0.836，95% CI，0.795-0.876），其次是梯度提升分类器（0.810，95% CI，0.750-0.868）、AdaBoost 分类器（0.776，95% CI，0.722-0.829）、随机森林分类器（0.735，95% CI，0.698-0.771）和 XGBoost 分类器（0.721，95% CI，0.695-0.747）。与多变量逻辑回归模型相比，逻辑回归分类器的AUROC更高（0.836 vs. 0.623，P < 0.001）。在用于构建逻辑回归分类器的各种参数中，最重要的前三个特征是手术时间（0.999）、术前血清血红蛋白水平（0.785）和开放手术（0.530）：我们利用现成的术前数据成功开发了多种 ML 分类器，用于预测非心脏手术患者的术中输血情况。尤其是逻辑回归分类器在预测术中输血方面表现最佳。

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引用次数: 0

Recommandations pour la réalisation des examens d’immuno-hématologie de première intention par les laboratoires médicaux 关于医学实验室进行一线免疫血液学检测的建议。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2024.10.004

Patrick Joubaud , Jean-Marc Giannoli

The main objective of these recommendations for good practices is to supplement the regulatory provisions of the decree of May 15, 2018 which sets the conditions for performing erythrocyte immunohematology tests in medical biology, in order to clarify their application for medical laboratories which conduct first-line immunohematology tests: erythrocyte phenotyping and detection of anti-erythrocyte antibodies. These recommendations cover all phases of a biological examination (pre-analytical, analytical, and post-analytical) as defined in the Public Health Code (Article L6211-2).

Four levels of recommendations have been established:

● Recommended practices: complying with the requirements of the NF EN ISO 15189:2022 standard and ensuring optimal medical service delivery.

● Acceptable practices: situations which deviate from the best practices in immunohematology but still ensuring satisfactory patient management as well as transfusion and obstetrical safety.

● Non-recommended practices: not complying with the requirements of the NF EN ISO 15189:2022 standard and not allowing satisfactory patient management, but ensuring transfusion and obstetrical safety.

● Unacceptable practices: presenting a risk for transfusion or obstetrical complications.

Compliance with these recommendations optimizes patient medical care, particularly in transfusion or obstetrical contexts.

这些良好操作建议的主要目的是对2018年5月15日法令的监管规定进行补充，该法令规定了在医学生物学中进行红细胞免疫血液学检验的条件，以明确其对进行一线免疫血液学检验（红细胞表型和抗红细胞抗体检测）的医学实验室的适用性。这些建议涵盖了《公共卫生法》（第 L6211-2 条）中规定的生物检查的所有阶段（分析前、分析中和分析后）。建议分为四个等级：推荐实践：符合 NF EN ISO 15189:2022 标准的要求，确保提供最佳医疗服务。可接受的实践：偏离免疫血液学最佳实践的情况，但仍能确保令人满意的患者管理以及输血和产科安全。非推荐做法：不符合 NF EN ISO 15189:2022 标准的要求，无法对患者进行满意的管理，但仍能确保输血和产科安全。不可接受的操作：存在输血或产科并发症风险。遵守这些建议可优化患者医疗护理，尤其是在输血或产科情况下。

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引用次数: 0

Developing a veno-venous extracorporeal membrane oxygenation program during the COVID-19 pandemic: Don’t forget to notify the blood bank 在 COVID-19 大流行期间制定静脉体外膜氧合计划：别忘了通知血库。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2024.10.008

Alexis Berger , Christophe Lelubre , Charles Chevalier , Jacqueline Massart , David Fagnoul , Steeve Dangotte , Sotirios Marinakis , Karim Homsy , Badih Elnakadi , Patrick Biston , Michael Piagnerelli

Objectives

During the SARS-CoV-2 pandemic, there has been significant increased use of vvECMO as rescue therapy. Patients with COVID-19 as anticoagulation is needed for vvECMO support, may develop bleeding complications requiring an increased number of RBC transfusions. We would like to report the RBC transfusion needs following the implementation of an ECMO program. Data on blood usage in this population is important in view of the decline in donations due to the pandemic.

Study Design and Methods

We analyzed data on RBC transfusions in patients who required vvECMO for COVID-19 related ARDS in a Belgian ICU from March 2020 to March 2022. The primary end point was RBC transfusion requirements. and the relationship to outcome. We also analyzed the evolution of this requirement during the four waves.

Results

We admitted 538 patients for hypoxemic ARDS due to COVID-19. Sixty patients (11%) required vvECMO, of whom 27 (45%) died. Forty-seven (78%) of the vvECMO patients were transfused a total of 403 packed RBC units. Sites of hemorrhagic complications were ECMO cannulation sites and lungs. RBC transfusion per patient per day on vvECMO was 0.50 [0.30–0.67] units. There were no differences in hemorrhagic complications in vvECMO survivors and non-survivors.

The percentage of vvECMO patients receiving a RBC transfusion increased slightly during the last COVID-19 wave, with 92 % of patients transfused.

Conclusions

vvECMO program is associated with a major need for RBC transfusions. These data are important when blood availability is decreased due to a pandemic and illustrates the need for studies on optimizing blood management including therapeutic anticoagulation target, threshold for RBC transfusion or alternatives to RBC transfusion.

目的：在 SARS-CoV-2 大流行期间，vvECMO 作为抢救疗法的使用显著增加。由于 vvECMO 支持需要抗凝，COVID-19 患者可能会出现出血并发症，需要输注更多的红细胞。我们希望报告实施 ECMO 计划后的红细胞输注需求。鉴于大流行导致献血量减少，有关该人群用血情况的数据非常重要：我们分析了比利时一家重症监护室在 2020 年 3 月至 2022 年 3 月期间因 COVID-19 相关 ARDS 而需要 vvECMO 的患者的 RBC 输血数据。主要终点是RBC输血需求及其与预后的关系。我们还分析了四个阶段中这一需求的变化情况：我们收治了 538 名因 COVID-19 引起的低氧血症 ARDS 患者。60名患者（11%）需要vvECMO，其中27人（45%）死亡。47名（78%）vvECMO患者共输注了403个包装红细胞单位。出血并发症的部位是 ECMO 插管部位和肺部。vvECMO 患者每人每天的红细胞输注量为 0.50 [0.30-0.67] 个单位。vvECMO 存活者和非存活者的出血并发症没有差异。在上一次COVID-19调查中，vvECMO患者接受红细胞输血的比例略有上升，92%的患者接受了输血。这些数据在血液供应因大流行而减少时非常重要，说明有必要研究如何优化血液管理，包括治疗性抗凝目标、输注红细胞的阈值或红细胞输注的替代方案。

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引用次数: 0

Acknowledging our reviewers 2024

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/S1246-7820(25)00034-5

引用次数: 0

Beyond royalty: Unraveling the mystery of bluish discolouration in the blood transfusion set 超越皇室揭开输血组变色发蓝的神秘面纱。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2024.10.005

Manish Raturi , Rolika Nautiyal , Viney Kumar , Yashaswi Dhiman , Dushyant Singh Gaur , Hem Chandra

引用次数: 0

Effect of platelet storage duration on platelet increment and clinical outcomes in critically ill patients – A randomised controlled trial 血小板储存时间对重症患者血小板增量和临床疗效的影响--随机对照试验。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2024.11.001

Vivek Muraleedharan , Paramjit Kaur , Kshitija Mittal , Sanjeev Palta , Ravneet Kaur , Gagandeep Kaur

Background and objectives

Platelet storage duration may influence transfusion effectiveness and patient outcomes.The present study aimed to evaluate the effect of platelet storage duration on platelet increment and clinical outcomes in patients admitted to the intensive care unit (ICU).

Material and methods

This prospective, open-label, randomized controlled trial, conducted at a single centre, enrolled ICU patients requiring platelet transfusion. Patients were randomly assigned to receive platelet concentrates aged ≤ 3 days (Group 1) or 4–5 days (Group 2). Platelet increments were assessed by Absolute Platelet Count Increment (ACI), Corrected Count Increment (CCI), and Percentage Platelet Recovery (PPR). Clinical outcomes including bleeding, infection rates, ICU stay, red cell transfusion requirements, and mortality were also monitored.

Results

Patients transfused fresher platelets (Group 1) had higher median ACI, CCI and PPR at 1 h compared to those transfused older platelets (Group 2) though the difference was not statistically significant. At 24 h, Group 1 patients had a median ACI of 28,000/µl compared to 14,000/µl in Group 2(p = 0.001). The median CCI was 16,800 in Group 1 versus 8,200 in Group 2(p = 0.001). Group 1 also had a higher median PPR of 45.7% compared to 23.6% in Group 2(p = 0.011).There was no significant difference in clinical outcomes such as bleeding, infection rates, ICU stay, or mortality between the groups. Multivariate analysis indicated that co-morbidities and higher APACHE-III score were associated with increased mortality.

Conclusion

Transfusion of fresher platelets resulted in higher increments and transfusion effectiveness but did not affect clinical outcomes or mortality.

Trial registration details

Clinical Trials Registry of India (CTRI/2023/03/050676).

背景和目的：本研究旨在评估血小板储存时间对重症监护病房（ICU）患者血小板增量和临床疗效的影响：这项前瞻性、开放标签、随机对照试验在一个中心进行，招募了需要输注血小板的重症监护病房患者。患者被随机分配接受≤3 天（第 1 组）或 4-5 天（第 2 组）的血小板浓缩液。血小板增量通过血小板绝对计数增量（ACI）、校正计数增量（CCI）和血小板恢复百分比（PPR）进行评估。此外，还对出血、感染率、重症监护室住院时间、红细胞输注需求和死亡率等临床结果进行了监测：结果：输注较新鲜血小板的患者（第 1 组）与输注较陈旧血小板的患者（第 2 组）相比，1 小时后的 ACI、CCI 和 PPR 中位数更高，但差异无统计学意义。第 1 组患者的 CCI 中位数为 16 800，而第 2 组为 8 200（P = 0.001）。第 1 组的中位 PPR 也更高，为 45.7%，而第 2 组为 23.6%（P = 0.011）。两组之间在出血、感染率、重症监护室住院时间或死亡率等临床结果方面没有显著差异。多变量分析表明，合并疾病和 APACHE-III 评分越高，死亡率越高：结论：输注更新鲜的血小板可获得更高的增量和输注效果，但不会影响临床结果或死亡率。试验登记详情：印度临床试验注册中心（CTRI/2023/03/050676）。

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引用次数: 0

Prevalence and risk factors of alloimmunization in multi-transfused pediatric patients: A cross-sectional study from a sub-Himalayan tertiary care hospital in Uttarakhand India 多重输血的儿科患者中的自身免疫流行率和风险因素：印度北阿坎德邦一家次喜马拉雅地区三级医院的横断面研究。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2024.10.007

Rajat Maini , Anil Kumar Rawat , Rakesh Kumar , Manish Raturi

Background

Packed red blood cell (PRBC) transfusion is critical in managing pediatric patients with conditions requiring frequent transfusions, such as leukemia, thalassemia, and bone marrow disorders. Alloimmunization, the formation of antibodies against foreign antigens present in the donor's blood, is a significant complication of repeated transfusions. Further, auto/alloimmunization is influenced by multiple factors, including antigenic differences between donor and recipient and the recipient’s immune status.

Objectives

This study aimed to assess the prevalence and risk factors of auto/alloimmunization among pediatric patients undergoingmultiple PRBC transfusions in a tertiary care hospital in the sub-Himalayan region of Uttarakhand, India.

Methods

A cross-sectional study was conducted on 113 multi-transfused pediatric patients aged 4 months to 18 years who received more than one PRBC transfusion between September 2022 and August 2023. Antibody screening and identification were performed using column agglutination techniques. Statistical analysis was conducted to evaluate associations between demographic, clinical factors, and antibody detection.

Results

Alloimmunization was observed in 5.31% of patients, with the majority developing antibodies against the MNS blood group system. Autoantibodies were more common, detected in 17.7% of patients. Significant associations were found between the history of prior PRBC transfusions and the formation of alloantibodies (p = 0.005). Age, gender, and ethnicity did not show a statistically significant association with antibody detection.

Conclusions

The study reveals a relatively higher prevalence of autoimmunization among multi-transfused pediatric patients. The history of PRBC transfusions was a significant risk factor, indicating the need for extended RBC phenotyping and tailored transfusion strategies to reduce alloimmunization risks in these patients. Most patients and blood donors in this region belong to the local Garhwali community. This homogeneity may help explain the lower rate of alloimmunization observed, suggesting a degree of antigenic similarity among the blood donors and the recipients.

背景：输注成组红细胞（PRBC）对于治疗白血病、地中海贫血和骨髓疾病等需要频繁输血的儿科患者至关重要。异体免疫（针对献血者血液中的外来抗原形成抗体）是反复输血的一个重要并发症。此外，自身/同种免疫受多种因素影响，包括供血者和受血者之间的抗原差异以及受血者的免疫状态：本研究旨在评估印度北阿坎德邦次喜马拉雅地区一家三级医院中需要多次输注 PRBC 的儿科患者自身/高免疫的患病率和风险因素：对 2022 年 9 月至 2023 年 8 月期间接受过一次以上 PRBC 输血的 113 名 4 个月至 18 岁的多次输血儿科患者进行了横断面研究。采用柱凝集技术进行抗体筛查和鉴定。统计分析评估了人口统计学、临床因素和抗体检测之间的关联：结果：5.31%的患者出现了同种免疫，其中大多数人产生了针对 MNS 血型系统的抗体。自身抗体更为常见，在 17.7% 的患者中检测到。既往PRBC输血史与出现同种抗体之间存在显著关联（P=0.005）。年龄、性别和种族与抗体检测没有统计学意义：研究显示，多次输血的儿科患者中自身免疫的发病率相对较高。结论：该研究显示，多次输血的儿科患者中自身免疫的发生率相对较高，PRBC 输血史是一个重要的风险因素，这表明有必要扩大 RBC 表型检测范围并制定有针对性的输血策略，以降低这些患者的自身免疫风险。该地区的大多数患者和献血者都属于当地的 Garhwali 族群。这种同质性可能有助于解释所观察到的较低的同种免疫率，表明献血者和受血者之间存在一定程度的抗原相似性。

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引用次数: 0

Reducing deterrents to engage in plasmapheresis donation: Evaluation of an experimental flyer 减少参与血浆置换捐献的阻碍：实验性传单的评估。

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique

Pub Date : 2025-02-01 DOI: 10.1016/j.tracli.2025.01.003

Antoine Beurel-Tréhan , Florence Terrade , Jean-Pierre Lebaudy , Bruno Danic

Objectives

This study aimed to measure the psychometrics qualities of an extended model of the Theory of Planned Behavior (TPB) applied to plasma donation, and its relevance in the evaluation of interventions aiming at converting whole-blood donors (WBD) to plasma donation.

Methods

Two studies were conducted. The first (N = 433) compared the efficacy of two communication strategies (standard strategy centered on motivations to donate vs. experimental strategy centered on barriers to donate) for influencing specific determinants of the extended model of the TPB and for engaging WBD in plasma donation. The second study (N = 309) evaluated the gain of adding to the experimental strategy an implementation intentions protocol to facilitate the behavior.

Results

Study 1 showed the relevance of the extended model as a measurement tool of intention’s determinants, and the efficacy of the experimental strategy compared to the standard approach to bolster intention, F(2,430) = 7.03, p < 0.001, partial η² = 0.032, and to increase the likelihood of commitments χ2(2, N = 433) = 11.904, p = 0.003, Cramer’s V = 0.17. Study 2 replicated these results but did not demonstrate any effect of the implementation intentions protocol to strengthen the intervention, χ²(1, N = 188) = 1.341, p = 0.25.

Conclusions

These studies showed that addressing barriers to donation is an efficient communication and recruitment strategy. We encourage blood collection agencies to develop communication campaigns in this direction rather than focusing on donors motivations.

目的：本研究旨在测量计划行为理论（TPB）应用于血浆捐献的扩展模型的心理测量学质量，及其在旨在将全血献血者（WBD）转化为血浆捐献的干预措施评估中的相关性。方法：进行两项研究。第一项研究（N= 433）比较了两种沟通策略（以捐赠动机为中心的标准策略与以捐赠障碍为中心的实验策略）在影响TPB扩展模型的特定决定因素和让WBD参与血浆捐赠方面的效果。第二项研究（N= 309）评估了在实验策略中加入实施意图协议以促进行为的收益。结果：研究1显示了扩展模型作为意向决定因素的测量工具的相关性，与标准方法相比，实验策略在增强意向方面的有效性，F(2,430)= 7.03, p< 0.001，偏η2= 0.032，并增加承诺可能性χ2(2， N= 433)= 11.904, p= 0.003, Cramer's V= 0.17。研究2重复了这些结果，但没有证明实施意图方案对加强干预有任何影响，χ2(1， N= 188)= 1.341, p= 0.25。结论：这些研究表明，解决捐赠障碍是一种有效的沟通和招募策略。我们鼓励采血机构在这方面开展宣传活动，而不是侧重于献血者的动机。

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引用次数: 0