Alteraciones en los parámetros hematológicos en postulantes a donar sangre en un hospital general de Lima, Perú
Palabras clave:
recuento de células sanguíneas, bancos de sangre, donantes de sangre, anemia, trastornos leucocíticos
Resumen
Introducción: la seguridad transfusional se basa en la obtención de sangre segura de un donante sano. El conocimiento básico sobre las alteraciones hematológicas más frecuentes podría ayudar a generar estrategias para la selección del donante de sangre.
Objetivo: determinar la frecuencia de alteraciones en el recuento de células sanguíneas en postulantes a donar sangre.
Materiales y métodos: se realizó un estudio transversal en el Servicio de Hemoterapia y Banco de Sangre del Hospital Nacional Cayetano Heredia en Lima, Perú, a partir de la revisión de historias clínicas de 610 postulantes a donar sangre durante el mes de agosto del 2022. Se revisaron datos demográficos (edad y sexo) y el perfil hematológico. Se realizó una estadística descriptiva para presentar los datos del estudio.
Resultados: el rango de edad fue entre 29 y 39 años y predominó el sexo masculino (64,2%). La frecuencia de alteraciones hematológicas fue 27,2%. La macrocitosis fue el hallazgo más común en la serie roja (14%). La anemia fue más frecuente en mujeres (84,6%), siendo la anemia microcítica y microcítica hipocrómica los
hallazgos más observados en este grupo. La trombocitopenia y la leucocitosis fueron más comunes en el sexo masculino con 83,3 % y 61% respectivamente.
Conclusiones: se describe una elevada frecuencia de anormalidades hematológicas, por tanto, el solo uso de la hemoglobina en la selección no es suficiente para establecer ausencia de estas alteraciones en postulantes a donar sangre.
Citas
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3. Kasraian L, Negarestani N. Rates and reasons for blood donor deferral, Shiraz, Iran. A retrospective study. Sao Paulo Med J [Internet]. 2015 [cited 2023 Dec 15]; 133(1):36-42. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496620. doi: 10.1590/1516-3180.2013.7110002
4. Szczepiorkowski Z President, Hopkins T Chief Executive Officer. Updated strategies to limit or prevent iron deficiency in blood donors. Association Bulletin [Internet]. 2022 [cited 2023 Dec 15]; 17(02): [1-12]. Available from: https://www.aabb.org/docs/default-source/default-document-library/resources/association-bulletins/ab17-02.pdf
5. Ministerio de Salud. Resolución Ministerial N° 241-2018-MINSA [Internet]. Lima: Ministerio de Salud; 2018. [citado 15 Dic 2023]. Disponible en: https://www.gob.pe/institucion/minsa/normas-legales/187434-241-2018-minsa
6. Mast AE. Low hemoglobin deferral in blood donors. Transfus Med Rev [Internet]. 2014 [cited 2023 Dec 15];28(1):18–22. Available from: https://pubmed.ncbi.nlm.nih.gov/24332843. doi: 10.1016/j.tmrv.2013.11.001
7. Cabracancha Gómez GJ, Córdova Carrión G. Causas de diferimiento y rechazo en predonantes de sangre que acudieron al Hospital Nacional Guillermo Almenara Irigoyen, Lima Junio - Julio 2017 [Tesis]. [Internet]. Lima: Universidad Norbert Wiener, Facultad de Ciencias de la Salud, Escuela Académico Profesional de Tecnología Médica; 2019. [citado 15 Dic 2023]. Disponible en: https://repositorio.uwiener.edu.pe/bitstream/handle/20.500.13053/2915/TESIS%20Cabracancha%20Gladys%20-%20C%c3%b3rdova%20Giovanna.pdf?sequence=1&isAllowed=y
8. Sultan S, Irfan SM, Baig MA, Usman SM, Shirazi UA. Insight into donor deferral pattern based on peripheral blood counts: An experience from South Pakistan. Asian J Transfus Sci [Internet]. 2017 [cited 2023 Dec 15]; 11(2):151–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613423. doi: 10.4103/0973-6247.214357
9. Bisseye C, Ntsame Ndong JM, Mombo LE, Minkoue Mambéri HCh, Migolet GM, Taty-Taty GC, Nagalo BM. Hemogram abnormalities in apparently healthy first-time blood donors in Libreville, Gabon. Sud J Med Sc [Internet]. 2019 [cited 2023 Dec 15]; 14(3)103–15. Available from: https://kneopen.com/SJMS/article/view/5210. doi: 10.18502/sjms.v14i3.5210
10. Bakrim S, Ouarour A, Jaidann K, Benajiba M, Masrar A. [Hemogram profile and interest of pre-donation hemoglobin measurement in blood donors in the northwest region of Morocco]. Transfus Clin Biol. 2018;25(1):35–43. doi: 10.1016/j.tracli.2017.10.006
11. Coluzzi S, Mascaretti L. Insights and innovations in Blood Transfusion. Blood Transfus. 2024 Jul;22(4):277-278. doi: 10.2450/BloodTransfus.845.
12. Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832–43. doi: 10.1056/NEJMra1401038
13. Tiwari AK, Bhardwaj G, Arora D, Aggarwal G, Pabbi S, Dara RC, et al. Applying newer parameter Ret-He (reticulocyte haemoglobin equivalent) to assess latent iron deficiency (LID) in blood donors-study at a tertiary care hospital in India. Vox Sang. 2018;113(7):639–46. doi: 10.1111/vox.12700
14. Curry ChV. Differential blood count [Internet]. Medscape. 2019 [cited 2023 Dec 15]. Available from: https://emedicine.medscape.com/article/2085133-overview#a2
15. Rabeya Y, Rapiaah M, Rosline H, Ahmed SA, Zaidah WA, Roshan TM. Blood pre-donation deferrals--a teaching hospital experience. Southeast Asian J Trop Med Public Health. 2008;39(3):571–4 Available from: https://pubmed.ncbi.nlm.nih.gov/18564700.
16. Zou S, Musavi F, Notari EP, Rios JA, Trouern-Trend J, Fang ChT. Donor deferral and resulting donor loss at the American Red Cross Blood Services, 2001 through 2006. Transfusion. 2008;48(12):2531–9. doi: 10.1111/j.1537-2995.2008.01903.x
17. Alves da Silva M, Volpe de Souza RA, Meneses Carlos A, Soares S, Moraes-Souza H, de Araujo Pereira G. Etiology of anemia of blood donor candidates deferred by hematologic screening. Rev Bras Hematol Hemoter [Internet]. 2012 [cited 2023 Dec 15];34(5):356–60. Available from: https://pubmed.ncbi.nlm.nih.gov/23125544. doi: 10.5581/1516-8484.20120092
18. Shrivastava M, Shah N, Navaid S, Agarwal K, Sharma G. Blood donor selection and deferral pattern as an important tool for blood safety in a tertiary care hospital. Asian J Transfus Sci [Internet]. 2016 [cited 2023 Dec 15];10(2):122–6. Available from: https://pubmed.ncbi.nlm.nih.gov/27605848. doi: 10.4103/0973-6247.187938
19. Céspedes IC, Figueiredo MS, Hossne NA Junior, Suriano ÍC, Rodrigues RC, Barros MMO, et al. Patient Blood Management Program Implementation: Comprehensive Recommendations and Practical Strategies. Braz J Cardiovasc Surg. 2024 Aug 2;39(5):e20240205. doi: 10.21470/1678-9741-2024-0205.
20. Ogar Ogar Ch, Okpokam DCh, Okoroiwu HU, Okafor IM. Comparative analysis of hematological parameters of first-time and repeat blood donors: Experience of a blood bank in southern Nigeria. Hematol Transfus Cell Ther [Internet]. 2022 [cited 2023 Dec 15]; 44(4):512–8. Available from: https://www.sciencedirect.com/science/article/pii/S2531137921001243. doi: https://doi.org/10.1016/j.htct.2021.06.013
21. Ahmed SG, Kagu MB, Abjah UAM. Haematological parameters of blood donors in North East Nigeria and the implication on quality of blood products. Africa Sanguine [Internet]. 2010 [cited 2023 Dec 15]; 13 (1): 5-8. Available from: https://www.researchgate.net/publication/263304607_HAEMATOLOGICAL_PARAMETERS_OF_BLOOD_DONORS_IN_NORTH_EAST_NIGERIA_AND_THE_IMPLICATION_ON_QUALITY_OF_BLOOD_PRODUCTS
22. Bani M, Giussani B. Gender differences in giving blood: a review of the literature. Blood Transfus [Internet]. 2010 [cited 2023 Dec 15];8(4):278–87. Available from: https://pubmed.ncbi.nlm.nih.gov/20967170. doi: 10.2450/2010.0156-09
23. Glynn SA, Kleinman SH, Schreiber GB, Zuck T, Combs SM, Bethel J, et al. Motivations to donate blood: demographic comparisons. Transfusion. 2002;42(2):216–25. doi: 10.1046/j.1537-2995.2002.00008.x
24. Valerian DM, Mauka WI, Kajeguka DC, Mgabo M, Juma A, Baliyima L, Sigalla GN. Prevalence and causes of blood donor deferrals among clients presenting for blood donation in northern Tanzania. PLoS One [Internet]. 2018 [cited 2023 Dec 15];13(10): e0206487. Available from: https://pubmed.ncbi.nlm.nih.gov/30359434. doi: 10.1371/journal.pone.0206487
25. Custer B, Johnson ES, Sullivan SD, Hazlet TK, Ramsey SD, Hirschler NV, et al. Quantifying losses to the donated blood supply due to donor deferral and miscollection. Transfusion. 2004; 44(10):1417–26. doi: 10.1111/j.1537-2995.2004.04160.x
26. Escobar Gamero JJ. Prevalencia de alteraciones en el hemograma automatizado en donantes de un banco de sangre tipo 2 de una clínica de Lima en el periodo comprendido entre setiembre del año 2015 y agosto del año 2016 [Tesis]. [Internet]. Lima: Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Escuela Profesional de Tecnología Médica; 2018. [citado 15 Dic 2023]. Disponible en: https://cybertesis.unmsm.edu.pe/backend/api/core/bitstreams/4bbf2e2d-41f3-482f-ac36-14b8e029cea8/content
27. Vega J, Younes M, Kuriakose P. The significance of unexplained macrocytosis. Blood [Internet]. 2008 [cited 2023 Dec 15];112(11):3449. Available from: https://www.sciencedirect.com/science/article/pii/S000649711950739X doi: https://doi.org/10.1182/blood.V112.11.3449.3449
28. Veda P. Evaluation of macrocytosis in routine hemograms. Indian J Hematol Blood Transfus [Internet]. 2013 [cited 2023 Dec 15];29(1):26–30. Available from: https://pubmed.ncbi.nlm.nih.gov/24426329. doi: 10.1007/s12288-011-0142-7
29. Oh RC, Holt SN, Hitchcock K, Hoekzema G. How do you evaluate macrocytosis without anemia? J Fam Pract. 2008;57(8):548–50
30. Keita I. Profil de l’hémogramme chez les donneurs volontaires de sang au Centre National de Transfusion Sanguine de Bamako, Mali [Tesis]. [Internet]. Malí: Université de Bamako, Faculté de Médecine, de Pharmacie et d’Odonto-Stomatologie (FMPOS); 2011. [susmentionné 15 Dec 2023]. Disponible dans: https://www.bibliosante.ml/handle/123456789/1859
31. Riley LK, Rupert J. Evaluation of patients with leukocytosis. Am Fam Physician [Internet]. 2015 [cited 2023 Dec 15];92(11):1004–11. Available from: https://pubmed.ncbi.nlm.nih.gov/26760415
32. Pujani M, Jyotsna PL, Bahadur S, Pahuja S, Pathak Ch, Jain M. Donor deferral characteristics for plateletpheresis at a tertiary care center in India- a retrospective analysis. J Clin Diagn Res [Internet]. 2014 [cited 2023 Dec 15]; 8(7):FC01–3. Available from: https://pubmed.ncbi.nlm.nih.gov/25177566 doi: 10.7860/JCDR/2014/8131.4563
33. Gauer RL, Whitaker DJ. Thrombocytopenia: Evaluation and management. Am Fam Physician. 2022;106(3):288–98
34. Food and Drug Administration, HHS. Requirements for blood and blood components intended for transfusion or for further manufacturing use. Final rule. Fed Regist [Internet]. 2015 [cited 2023 Dec 15];80(99):29841–906. Available from: https://pubmed.ncbi.nlm.nih.gov/26003966
35. Association for the Advancement of Blood & Biotherapies (AABB). Hemoglobin screening/Iron management [Internet]. Bethesda: AABB. [cited 2023 Enero 17]. Available from: https://www.aabb.org/regulatory-and-advocacy/regulatory-affairs/regulatory-for-blood/donor-safety-screening-and-testing/hemoglobin-screening-iron-management
36. López-Escobar A, Madurga R, Castellano JM, Ruiz de Aguiar S, Velázquez S, Bucar M, et al. Hemogram as marker of in-hospital mortality in COVID-19. J Investig Med. 2021; 69(5):962–9. doi: 10.1136/jim-2021-001810
