Normal red blood cells partially decrease diepoxybutane-induced chromosome breakage in cultured lymphocytes from Fanconi anaemia patients

Objectives: Fanconi anaemia (FA) is a cancer‐prone chromosome instability syndrome characterized by hypersensitivity to DNA cross‐linking agents, such as diepoxybutane (DEB). Previous studies have shown that normal red blood cells (RBC) can protect cultured lymphocytes against chromosomal breaks induced by DEB. The present study was designed to analyse influence of RBCs from normal individuals on frequency of DEB‐induced chromosome breaks in lymphocyte cultures from FA patients. Materials and methods: A comparative study was performed between DEB‐induced chromosome breaks in cultures of FA lymphocytes with either autologous or heterologous RBCs. A further comparative study was carried out between whole blood cultures from FA patients performed on two occasions, before and 1 week after transfusion of RBCs. Results: It was observed that normal RBCs compared to FA RBCs, partially reduced chromosome breaks in cultured FA lymphocytes. A significant reduction in DEB‐induced breaks was also observed in FA cultured lymphocytes obtained 1 week after transfusion of RBCs, in comparison to those observed in the same patients before RBC transfusion. Conclusions: This study shows that DEB‐induced chromosome instability in FA lymphocytes is partially reduced by normal RBCs. This effect may have some clinical relevance in vivo, whenever FA patients receive a RBC transfusion.     

Chromosome studies in newborn infants following exchange transfusion using countersexual blood]

The chromosomes of 6 (5 females, 1 male) newborns have been examined before and after exchange transfusion. The highest percentage of donor lymphocytes has been found immediately after the exchange transfusion (9%, range 5 to 16%). The percentage of donor lymphocytes had decreased to 4% after 24 hours and to 1% after 3 weeks. There was no hint of a clastogenic effect of phototherapy and exchange transfusion.     

神经外科手术中大量输血患者红细胞压积及凝血状态研究

摘要 目的：探讨神经外科手术中大量输血患者采用不同输血方法对红细胞压积及凝血状态的影响。方法：选择2017年2月至2019年12月在本院进行手术的神经外科患者104例,根据随机数字表法把患者分为观察组与对照组各52例。观察组给予自体输血治疗,对照组给予异体输血治疗,记录和比较患者红细胞压积及凝血状态变化情况。结果：所有患者都完成手术,两组的手术时间、术中输血量与补液量对比差异无统计学意义(P>0.05)。两组术后1 d的红细胞压积低于术前1 d(P<0.05),组间手术前后对比差异都无统计学意义(P>0.05)。两组术后1 d的凝血酶原时间(prothombin time,PT)与活化部分凝血活酶时间(activited partial thomboplastin time,APTT)值高于术前1 d(P<0.05),组间手术前后对比差异都无统计学意义(P>0.05)。观察组输血后7 d的感染发生率为1.9 %,显著低于对照组的15.4 %(P<0.05)。结论：神经外科手术中大量输血中采用自体输血并不会影响患者的红细胞压积与凝血状态,不会增加输血难度与输血量,但能有效减少感染等不良反应。     

成份输血对胃癌术后血清IL-6、IL-10、COX-2、PGE_2含量的影响

目的：观察围手术期成份输血对胃癌患者炎症反应的影响。方法：随机选择胃癌病人分为3组：对照组,压积红细胞组,全血组。分别采用ELISA法和放免法检测患者术前及术后低1、3、7、14天血清中IL-6、IL-10、COX-2及PGE2含量。结果：手术后第一周是感染发生的主要时期,两周后,炎症反应基本消失,输血能升高患者血清中的促炎因子,降低抗炎因子IL-10的表达,但相对于输异体全血,输成份血能降低血清中COX-2、PGE2、IL-6的含量,升高血清IL-10的含量。结论：胃癌患者围手术期输血能促进机体的炎症反应,成份输血致炎效果弱于输异体全血。     

RhD正定型及不规则抗体筛查的临床意义分析

目的:探究RhD正定型及不规则抗体筛查在预防临床输血不良反应中的应用价值及临床意义。方法:回顾性分析2010年至2011年、2017年至2018年于首都医科大学附属北京同仁医院输血科实施输血治疗的1892例患者,将2010年至2011年未实施Rh D正定型及不规则抗体筛查时输血治疗的901例患者设为对照组,将2017年至2018年实施RhD正定型及不规则抗体筛查后输血治疗的991例患者设为观察组。对比两组输血不良反应发生率,分析不同血液成分、不同性别、不同年龄输血不良反应发生率,并就2017年、2018年受血者RhD正定型及不规则抗体特异性分布进行罗列。结果:(1)2010年输血不良反应发生率为3.49%,2011年为2.40%,2017年为1.33%,2018年为0.74%,对照组不良反应发生率明显高于观察组(P<0.05)。(2)观察组不同血液成分输血的不良反应发生率显著低于对照组(P<0.05)。(3)两组不同年龄和性别输血不良反应发生率对比差异无统计学意义(P>0.05)。(4)观察组共检出20例RhD正定型及不规则抗体阳性患者,其中抗-M型5例,抗-D型3例,抗-E型2例,抗-C型2例,抗-P型2例,抗-LEa型1例,抗-LEb型1例,抗-JKa型1例,抗-N型1例,抗-H型1例,非特异性抗体1例。结论:RhD正定型及不规则抗体筛查能够显著降低输血不良反应发生率,有助于提高配血的准确性,提高输血治疗的安全性。     

Prospective investigation of transfusion transmitted infection in recipients of over 20 000 units of blood. TTI Study Group

ObjectivesTo follow up recipients of 20 000 units of blood to identify any transmissions of infections through blood transfusion.DesignFollow up study of recipients of transfusion.Setting 22 hospitals in north London.ParticipantAdult patients who had recently been transfused.Results9220 patients were recruited, and 5579 recipients of 21 923 units of blood were followed up. No transfusion transmitted infections were identified. The incidence of transfusion transmitted infections was 0 in 21 043 units (95% confidence interval for risk 0 to 1 in 5706 recipients) for hepatitis B; 0 in 21 800 units (0 to 1 in 5911 recipients) for hepatitis C; 0 in 21 923 units (0 to 1 in 5944 recipients) for HIV; and 0 in 21 902 units (0 to 1 in 5939 recipients) for human T cell leukaemia/lymphoma virus. Three patients acquired hepatitis B during or after hospital admission but not through transfusion; 176 (3%) had pre-existing hepatitis B infection. Sixteen (0.29%) patients had hepatitis C, and five (0.09%) had human T cell leukaemia/lymphoma virus.ConclusionsThe current risk of transfusion transmitted infections in the United Kingdom is very small, though hospital acquired infections may arise from sources other than transfusion. A considerable proportion of patients have pre-existing infections.     

Blood transfusion induced changes in cell-mediated lympholysis: to immunize or not to immunize

We have recently observed that the HLA-DR match between recipients and transfusion donors influences the beneficial effect of blood transfusions on allograft survival. To examine the immunologic effects of one-HLA-DR-Ag-matched and completely DR-mismatched transfusions, transfusion-induced changes in cell-mediated lympholysis (CML) were investigated. Blood donor directed CTL activity was measured in vitro before and after blood transfusion in 56 candidates for organ transplantation who received planned HLA-typed blood. We report that blood donor-directed CTL activity increased substantially after a single transfusion mismatched with the recipient for two HLA-DR Ag (p less than 0.0001). A transfusion matched for one HLA-DR Ag did not enhance CTL activity. No correlation was found between CTL reactivity and sharing of HLA class I Ag. The present study supports our previous observation that matching for at least one HLA class II Ag (HLA-DR) between transfusion recipient and blood donor is required if immunization by blood transfusion is to be avoided. These data show that the presence or absence of "autologous" HLA-DR Ag on the leucocytes of the transfusion donor plays a decisive rol whether immunization or immune suppression will ensue.     

Consequences of fetomaternal haemorrhage after intrauterine transfusion.

Fetomaternal haemorrhage was studied after 68 consecutive fetal intravascular transfusions performed in 20 patients with Rh isoimmunisation. alpha Fetoprotein concentration was assayed in maternal blood taken before, and immediately after each transfusion and three and 24 hours later. An increase of 50% or more in the concentration in any of the samples after transfusion was considered to indicate fetomaternal haemorrhage. Fetal alpha fetoprotein concentration in blood sampled before transfusion was also assayed and the amount of fetomaternal haemorrhage calculated. Fetomaternal haemorrhage occurred in 21 of 32 patients with an anterior placenta and in six of 36 with a posterior or fundal placenta. The mean estimated volume of haemorrhage was 2.4 ml, which was on average equal to 3.1% of the total fetoplacental blood volume. When the volume of fetomaternal haemorrhage at the first transfusion was greater than 1 ml there was a greater increase in maternal Rh (D) antibody titres and a greater fall in fetal packed cell volume. Sampling of fetal blood should not be routinely done early in patients with Rh isoimmunisation, and intrauterine transfusion should be delayed as long as possible. Sampling sites other than the placental cord insertion reduces the risk of fetomaternal haemorrhage.     

不同比例新鲜冰冻血浆对大量输血患者凝血功能的影响

目的:探讨不同比例输注新鲜冰冻血浆对大量输血患者凝血功能的影响。方法:回顾性分析本院2018年1月至2018年12月收治的123例大量输血患者的临床资料,依据所输注新鲜冰冻血浆与红细胞比例不同,将其分为低比例组(1:3)、中比例组(1:2)、高比例组(1:1),比较三组患者输血前后凝血功能、血小板计数及电解质变化。结果:输血后,三组患者FIB较输血前明显降低,而PT、APTT较输血前显著升高(P0.05),高比例组PT和APTT明显低于中比例组和低比例组,FIB、血小板均高于中比例组和低比例组(P0.05),电解质水平优于低比例组和中比例组(P0.05)。结论:在大量输血时,提高血浆与红细胞比例有利于改善大量输血患者凝血功能障碍,减少电解质紊乱。     

贮存式自体成分输血对胃肠肿瘤根治术患者T淋巴细胞亚群、血液流变学和预后的影响

摘要 目的：研究贮存式自体成分输血对胃肠肿瘤根治术患者T淋巴细胞亚群、血液流变学以及预后的影响。方法：选取2016年12月~2017年12月我院收治的95例行胃肠肿瘤根治术的胃肠肿瘤早期患者作为研究对象。按随机数表法分为A组（n=47,贮存式自体成分输血）和B组(n=48,异体成分输血)。比较两组患者血常规指标[红细胞计数(RBC)、血红蛋白（Hb）、血细胞比容（Hct）]、免疫功能指标（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）、血液流变学指标[红细胞沉降率、平均血液黏度、红细胞刚性指数及红细胞变形指数]的变化。随访患者2年,采用Kaplan-Meier曲线分析两组预后情况。结果：术前至术后7 d 时间段A组的CD3⁺、CD4⁺水平及CD4⁺/CD8⁺呈先降低后升高趋势,且术后7 d已恢复至术前水平;B组术后1 d、3 d、7 d的CD3⁺、CD4⁺水平及CD4⁺/CD8⁺明显低于A组(P＜0.05),两组CD8⁺水平相比无差异(P＞0.05) 。两组术后7 d的RBC、Hct、Hb分别较输血前下降（P＜0.05）,但两组间比较差异无统计学意义(P＞0.05);两组患者术后7 d的红细胞沉降率均升高,但A组低于B组(P＜0.05) ,两组患者术后的红细胞变形指数、平均血液黏度和红细胞刚性指数比较无差异 (P＞0.05) 。Kaplan-Meier检验结果显示,A组较B组生存率明显升高（P＜0.05）。结论：贮存式自体成分输血对胃肠肿瘤根治术患者红细胞沉降率、细胞免疫功能的影响程度较异体成分输血减轻,且贮存式自体成分输血可以明显提高患者的术后生存率。     

The adaptive response of mouse tumours to anaemia and retransfusion

We have developed exchange transfusion methods to alter the hematocrit of tumour-bearing mice. The effects of anaemia and its correction by blood transfusion on the radiosensitivity of two mouse tumours (SCCVII/St and RIF-1) were studied using excision, in vivo/in vitro assay. An acute reduction in haematocrit caused a high degree of radioresistance equivalent to an increase in the hypoxic fractions by factors of 10 (SCCVII/St) and 30 (RIF-1). As the duration of the anaemia was prolonged, radioresistance was lost until within about 6 h normal radiosensitivity was observed even though the anaemia persisted. The restoration of the normal haematocrit by red blood cell transfusion after 24 h of anaemia caused increased radiosensitivity equivalent to a reduction in the hypoxic fraction by factors of 5 (SCCVII/St) and 10 (RIF-1), but again the effect was transient and normal radiosensitivity was re-established within 24-48 h of retransfusion. Measurements of 14C misonidazole (MISO) binding to RIF-1 tumours after these procedures indicated changes in the number of hypoxic cells which were qualitatively almost identical to those using the cell survival endpoint, leading us to believe that changes in oxygenation were responsible for the altered radiosensitivity. We feel that transfusion procedures could be used to advantage in the radiotherapy of some cancers.     

Evaluation of clinical efficacy of platelet substitution in acute leukemia using resonance thrombography

For evaluating the clinical effectiveness of thrombocyte substitution, the resonance thrombogram was registered before and after thrombocyte substitution in 50 patients with acute leukemia and the increase of thrombocytes (corrected increment) determined. Thrombocyte substitution led to a significant diminution of the platelet amplitude (p less than 0.01) and platelet value. The highest value of these alterations of parameters was reached 1 hour after transfusion, it was somewhat lower after 24 hours, yet the initial value was not reached again. Correlations could be found to exist between the platelet amplitude and the corrected thrombocyte increase 1 hour and 24 hours after transfusion. The resonance thrombography enables the successful control of thrombocyte substitution to be made and it is suitable for monitoring hemostasis in severe thrombocytopenia due to production.     

Role of 20-HETE in the pial arteriolar constrictor response to decreased hematocrit after exchange transfusion of cell-free polymeric hemoglobin.

The cerebrovascular response to decreases in hematocrit and viscosity depends on accompanying changes in arterial O2 content. This study examines whether 1) the arteriolar dilation seen after exchange transfusion with a 5% albumin solution can be reduced by the K(ATP) channel antagonist glibenclamide (known to inhibit hypoxic dilation), and 2) the arteriolar constriction seen after exchange transfusion with a cell-free hemoglobin polymer to improve O2-carrying capacity can be blocked by inhibitors of the synthesis or vasoconstrictor actions of 20-HETE. In anesthetized rats, decreasing hematocrit by one-third with albumin exchange transfusion dilated pial arterioles (14 +/- 2%; SD), whereas superfusion of the surface of the brain with 10 muM glibenclamide blocked this response (-10 +/- 7%). Exchange transfusion with polymeric hemoglobin decreased the diameter of pial arterioles by 20 +/- 3% without altering arterial pressure. This constrictor response was attenuated by superfusing the surface of the brain with a 20-HETE antagonist, WIT-002 (10 microM; -5 +/- 1%), and was blocked by two chemically dissimilar selective inhibitors of the synthesis of 20-HETE, DDMS (50 microM; 0 +/- 4%) and HET-0016 (1 microM; +6 +/- 4%). The constrictor response to hemoglobin transfusion was not blocked by an inhibitor of nitric oxide (NO) synthase, and the inhibition of the constrictor response by DDMS was not altered by coadministration of the NO synthase inhibitor. We conclude 1) that activation of K(ATP) channels contributes to pial arteriolar dilation during anemia, whereas 2) constriction to polymeric hemoglobin transfusion at reduced hematocrit represents a regulatory response that limits increased O2 transport and that is mediated by increased formation of 20-HETE, rather than by NO scavenging.     

Use of platelet concentrate in eastern Ontario.

To better understand the reasons for the increasing use of platelet concentrate in Canada, we undertook a 4-month study of platelet concentrate transfusion in six eastern Ontario hospitals in 1985. A total of 4801 units of platelet concentrate were transfused on 687 occasions to 303 patients; the average number of transfusions per patient was 2.3, the average number of units per transfusion 7.0 and the average number of units per patient 15.8. The cardiovascular service used the largest proportion of units (28%), aortocoronary bypass grafting being the most common procedure. The mean pretransfusion platelet count for the medical and oncology services was about 30.0 X 10(9)/L, compared with 155.5 X 10(9)/L for the cardiovascular service. An increment in platelet count 1 hour after transfusion was noted with 238 (75%) of the transfusions for which the data were available; the average increment was 3.4 X 10(9)/L per unit of platelet concentrate transfused. When the data for patients who did not respond were excluded, the average increment was 6.9 X 10(9)/L. Single-donor platelet concentrate was requested for only half of the transfusions to which no response was detected. The current medical literature supports the appropriate use of platelet concentrate in patients with thrombocytopenia due to chemotherapy, but prophylactic platelet transfusion for patients undergoing cardiovascular bypass procedures is being questioned. We advise continued surveillance of the use of these products and re-evaluation of the aims of platelet transfusion therapy.     

The first large-scale nucleic acid amplification testing (NAT) of donated blood using multiplex reagent for simultaneous detection of HBV, HCV, and HIV-1 and significance of NAT for HBV.

The first nationwide nucleic acid amplification testing (NAT) for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus type 1 (HIV-1) of voluntarily donated blood after serological pre-screening and before release of cellular components and plasma for fractionation was implemented by the Japanese Red Cross Blood Transfusion Services. From February 1, 2000 to April 30, 2001, specimens from 6,805,010 units of serologically negative donation were screened in minipools of 50 samples within 24 hr after blood donation by NAT using multiplex HBV/HCV/HIV-1 reagent for blood transfusion including short shelf-life platelets. Among them, 112 HBV DNA-positives, 25 HCV RNA positives and 4 HIV-1 RNA positives were screened out and we could prevent transfusion of these NAT positive units. Subtypes/genotypes of HBV DNA, adr/C, adw/A, adw/B, adw/C, ayr/C and ayw/D were found and adr/C was predominant. A total of 61.6 % of them (69/112) were negative by overnight EIA. Sixth three of HBV NAT-positive samples carried virus loads less than 10(4) copies/mL and 92.1 % of them (58/63) were negative by overnight EIA. The virus growth curves of HBV in 6 cases obtained by retrospective and prospective follow-up study showed exponential straight lines in the early stage of serological window periods and the log times of HBV growth (10 fold increase) in serological window period were between 4.6 and 7.6 days. NAT screening with highly sensitive reagents in pool of specimens is useful to exclude blood units with low level of HBV and HBV mutants from blood transfusion.     

Regional cerebral blood flow in cats with cross-linked hemoglobin transfusion during focal cerebral ischemia

The beneficial effect of hemodilution on cerebral blood flow (CBF) during focal cerebral ischemia is mitigated by reduced arterial oxygen content (CaO2). In anesthetized cats subjected to permanent middle cerebral artery occlusion, the time course of regional CBF was evaluated after isovolemic exchange transfusion with either albumin or a tetrameric hemoglobin-based oxygen carrier. The transfusion started 30 min after arterial occlusion. We tested the hypothesis that bulk oxygen transport (CBF x CaO2) to ischemic tissue is increased by hemoglobin transfusion at a hematocrit of 18% compared with albumin-transfused cats at a hematocrit of 18% or control cats at a hematocrit of 30% and equivalent arterial pressure. In the nonischemic hemisphere, CBF increased selectively after albumin transfusion, and oxygen transport was similar among groups. In the ischemic cortex, albumin transfusion increased CBF, but oxygen transport was not increased above that of the control group. Hemoglobin transfusion increased both CBF and oxygen transport in the ischemic cortex above values in the control group, but the increase was delayed until 4 h of ischemia. Consequently, acute injury volume measured at 6 h of ischemia was not significantly attenuated. In contrast to the cortex, CBF in the ischemic caudate nucleus was not substantially increased by either albumin or hemoglobin transfusion. Therefore, in a large animal model of permanent focal ischemia in which transfusion starts 30 min after ischemia, tetrameric cross-linked hemoglobin transfusion can augment oxygen transport to the ischemic cortex, but the increase can be delayed and not necessarily provide protection. Moreover, an end-artery region such as the caudate nucleus is less likely to benefit from hemodilution.     

Prospective study of post-transfusion hepatitis after cardiac surgery in a British centre.

A series of 248 consecutive patients undergoing cardiac surgery were examined in a prospective study of post-transfusion hepatitis in a single British centre. Patients received a total of 1796 units of blood or blood products (mean blood transfusion 6.28 units per patient). During five to 30 days after operation 38 of the patients showed an increase in serum transaminase activities. There was no serological evidence for fresh infection by hepatitis A or B virus, cytomegalovirus, Epstein-Barr virus, or herpes virus in any of these patients. The increase in transaminase activities was unexplained and reached over 100 IU/l (normal less than 40 IU/l) in six patients. The incidence of acute short incubation post-transfusion non-A, non-B hepatitis was therefore thought to be 2.4%. These six patients had normal liver function six months after transfusion but a further two of the surviving 228 patients had raised serum transaminase activities at six months. In one of these, liver biopsy disclosed chronic persistent hepatitis; in the other, alcoholic liver disease was suspected. The incidence of significant chronic liver disease after blood transfusion possibly attributable to a non-A, non-B hepatitis agent was therefore only 0.4%.     

自体CIK细胞联合化疗治疗老年急性白血病的临床疗效评估

目的:探讨自体细胞因子诱导杀伤(CIK)细胞联合化疗方案治疗老年急性白血病的临床疗效。方法:采集6例在我院进行化疗治疗的老年急性白血病患者的静脉血制备自体CIK细胞,成熟后回输入体内,持续注射10天为一个疗程。观察培养前和培养13天后白细胞各亚型细胞所占百分比,并比较CIK细胞回输前后患者白细胞亚群、感染次数及输血量的变化。结果:培养后CD3~+、CD8~+、CD3~+CD8~+、CD3~+CD56~+亚型细胞百分比均显著高于培养前(P0.05),CIK细胞回输后患者体内CD3~+、CD3~+CD8~+、CD3~+CD56~+亚群细胞百分比显著高于回输前(P0.05);CIK细胞回输后,患者感染次数和持续时间均显著少于回输前(P0.05),疾病稳定期输血量显著低于回输前(P0.05),疾病进展期输血量与回输前差异无显著性意义(P0.05)。结论:自体CIK细胞联合化疗治疗老年急性白血病患者有效且安全,可维持病情的稳定、提高机体细胞免疫功能和抗感染能力,值得临床推广。     

Dependence of acetylcholine and ADP dilation of pial arterioles on heme oxygenase after transfusion of cell-free polymeric hemoglobin

Polymers of cell-free hemoglobin have been designed for clinical use as oxygen carriers, but limited information is available regarding their effects on vascular regulation. We tested the hypothesis that the contribution of heme oxygenase (HO) to acetylcholine-evoked dilation of pial arterioles is upregulated 2 days after polymeric hemoglobin transfusion. Dilator responses to acetylcholine measured by intravital microscopy in anesthetized cats were blocked by superfusion of the HO inhibitor tin protoporphyrin-IX (SnPPIX) in a group that had undergone exchange transfusion with hemoglobin 2 days earlier but not in surgical sham and albumin-transfused groups. However, immunoblots from cortical brain homogenates did not reveal changes in expression of the inducible isoform HO1 or the constitutive isoform HO2 in the hemoglobin-transfused group. To test whether the inhibitory effect of SnPPIX was present acutely after hemoglobin transfusion, responses were measured within an hour of completion of the exchange transfusion. In control and albumin-transfused groups, acetylcholine responses were unaffected by SnPPIX but were blocked by addition of the nitric oxide synthase inhibitor N(omega)-nitro-l-arginine (l-NNA) to the superfusate. In hemoglobin-transfused groups, the acetylcholine response was blocked by either SnPPIX or l-NNA alone. The effect of another HO inhibitor, chromium mesoporphyrin (CrMP), was tested on ADP, another endothelial-dependent dilator, in anesthetized rats. Pial arteriolar dilation to ADP was unaffected by CrMP in controls but was attenuated 62% by CrMP in rats transfused with hemoglobin. It is concluded that 1) polymeric hemoglobin transfusion acutely upregulates the contribution of HO to acetylcholine-induced dilation of pial arterioles in cats, 2) this upregulation persists 2 days after transfusion when 95% of the hemoglobin is cleared from the circulation, and 3) this acute upregulation of HO signaling is ubiquitous in that similar effects were observed with a different endothelial-dependent agonist (i.e., ADP) in a another species (rat).     

医院输血安全管理现状分析与对策

目的：通过对某省七家三级医院输血科管理现状调查,了解医院在输血管理制度的制定与实施、技术操作的规范性、输血流程的安全性、输血科人员配置等方面存在的问题,明确今后医院输血安全管理工作的重点,并提出相应的管理对策,旨在为医院及政府职能部门制订有关医院输血安全相关策略提供科学的佐证。方法：1、文献法：对CNKI、维普数据库近五年相关文献进行系统回顾;2、现场调查：对某省7家三级医院输血安全管理现况调查。结果：所调查的7家医院输血安全管理制度知晓率较低,储血冰箱未按照正确的时间进行监测,医务人员对病人输血反应观察不到位,输血前医患沟通较好,输血差错自愿报告系统超过60%的医院尚未建立,输血不良事件发生后,只有14%的医护人员愿意主动上报,输血科医务人员30岁以上的不到30%,专科以下学历占66%,专业背景37%为检验专业,无学历的占8%。结论：医院输血安全管理存在许多问题：管理制度知晓率低、执行不到位,储血过程未按相关要求进行监测,输血科医务人员过于年轻化,学历层次较低,专业背景单一。建议医院应根据存在的问题,采取应对策略。