Clinical blood transfusion, as a vital medical intervention for patient treatment, carries inherent risks. Therefore, implementing systematic quality management of blood transfusion is crucial to ensuring transfusion safety. Investigations reveal that some medical institutions still suffer from overly complex and inefficient blood transfusion quality management systems, while a few institutions with relatively low blood usage lack or have incomplete quality management systems. In response, the Yangtze River Delta Integration Clinical Transfusion Quality Control and Management Consortium, Shanghai Clinical Transfusion Quality Control Center, Blood Transfusion Professional Committee of Shanghai Association of Social Medical Institutions, Blood Transfusion Branch of Shanghai Medical Association, and Blood Transfusion Physician Branch of Shanghai Medical Doctor Association organized a group of renowned domestic experts in transfusion medicine. Based on evidence-based medicine methods, they developed the Expert Consensus on Checklist-based Quality Management for the Entire Clinical Blood Transfusion Process. Centered on the transfusion workflow, this consensus defines 38 specific tasks across four dimensions: process, task, personnel, and requirements. It covers key stages including transfusion indication assessment, transfusion request and approval, blood transfusion compatibility testing, blood release, blood transfusion administration, and post-transfusion management, with clear definitions of responsible personnel and requirements for each task. Previously, this consensus has been registered on an international practice guideline platform (Registration Number: PREPARE-2025CN735). The consensus aims to use a checklist model to clarify the key steps and quality control points at each stage of clinical blood transfusion. It provides standardized, refined, and actionable guidance for medical institutions to standardize technical operations, reduce human errors, minimize transfusion risks, and systematically ensure clinical transfusion safety.

Objective To understand the distribution of RhD, C, c, E and e antigens among Chinese people in China, and to explore the genetic relationships of Rh blood type distribution across different regions and ethnic groups. Methods Data on the distribution of RhD, C, c, E, and e antigens from 1 048 519 Chinese individuals across 34 provinces, municipalities directly under the Central Government, and autonomous regions were collected for population genetic analysis. The maximum likelihood method was used to calculate the Rh gene frequency and haplotype frequency. The reliability of the data was evaluated by the Hardy-Weinberg equilibrium fit test. Results The distribution of Rh blood type in 34 provinces, municipalities and autonomous regions and 16 ethnic groups in China was consistent with Hardy-Weinberg equilibrium. The allele frequencies of RHD and RHCE, as well as the Rh haplotype frequencies, were associated with the subjects' place of origin. Among northerners and southerners, the RhD-positive rates were 99.55% and 99.61% respectively, and the RhD-negative rates were 0.45% and 0.39% respectively. The frequencies of DCe haplotype with Asian characteristics were 0.625 9 and 0.683 5, and the frequencies of the RHCE*Ce allele were 0.641 6 and 0.701 4, respectively. Conclusion The data analyzed in this report were collected nationwide using uniform standards, with over one million subjects examined. The derived data obtained through analysis can be used as control data for various regions in China and used in disease association studies, anthropological studies, and transfusion medicine research.

Pre-clinical blood transfusion testing in medical institutions is the most crucial inspection link in the clinical blood transfusion process. High-quality clinical pre-transfusion detection techniques and capabilities can minimize the risk of adverse reactions to blood transfusion to the greatest extent. Since the test results before clinical blood transfusion are the definitive diagnosis for the recipient (patient), whether the safety and effectiveness of blood transfusion can be ensured often depends on the accuracy and timeliness of the test results. Therefore, in order to ensure the safety and effectiveness of clinical blood transfusion, and to safeguard people's health and social stability, the expert consensus group has gathered experts and scholars in the field of clinical blood transfusion medicine and related disciplines in China. They have combined national laws and regulations, standardized documents, national health standards related to blood transfusion, and research results related to clinical blood transfusion to formulate this expert consensus. The aim is to further standardize the use of key equipment and reagents for pre-transfusion testing in the blood transfusion department (blood bank), as well as the detection capabilities of personnel.

The distribution of RhCE antigens in the Chinese populations differs from that in Caucasians and Africans, and genetic differences are also observed between northern and southern Chinese. The probability of RhCE antigen mismatch (23.6% to 26.31%) in Chinese transfusion patients is significantly higher than that of RhD antigen mismatch (0.39% to 0.45%), leading to a high incidence of RhCE alloantibodies in transfusion-related cases. Clinical transfusion studies indicate that RhCE antigen matching can reduce the risk of alloimmunization. This consensus proposes a RhCE antigen matching strategy for Chinese transfusion patients based on Landsteiner's rule and the distribution characteristics of RhCE antigens in the Chinese population.

Voluntary blood donation serves as a crucial pillar of the public health system. Currently, China's voluntary blood donation undertaking faces dual challenges of trust crisis under pandemic impacts and utilitarian-oriented advocacy, where fluctuating donor numbers and declining public trust form a vicious cycle. International practical experience demonstrates that cultivating social altruism through cultural immersion and intergenerational education mechanisms can effectively enhance the sustainability of blood donation behaviors. With growing medical demands and heightened public health awareness, there is an urgent need to re-examine the deep structural contradictions within the voluntary blood donation ecosystem. This study systematically analyzes the trust crisis triggered by instrumental advocacy under special circumstances from the perspective of the original public welfare attributes of blood donation, combining cross-national case comparisons and empirical data analysis to propose pathways for reconstructing the public welfare ecology. The research reveals that building a sense of responsibility for the community of shared life requires breakthroughs in three key dimensions: establishing a culturally embedded intergenerational value cultivation system, creating a fully transparent institutional trust mechanism, and developing intelligent blood donation service technologies. Theoretically, it demonstrates that the paradigm shift from interest-driven to value-identified donation behavior essentially represents a collective action upgrade through the reconstruction of social psychological contracts. Practically, it verifies that blockchain-integrated traceability systems can significantly enhance donor engagement, while culturally embedded advocacy strategies effectively improve long-term donor retention rates. Fundamentally, resolving post-pandemic challenges in voluntary blood donation lies in constructing a four-in-one public welfare ecology that integrates government guidance, social collaboration, value recognition, and technological support. This approach not only aligns with the Healthy China strategic orientation but also provides innovative paradigms for global blood safety governance.

Objective To elucidate the mechanisms of platelet antibody production, analyze their distribution across diverse populations, investigate associations with primary diseases and laboratory parameters, and assess their impact on test outcomes—with the ultimate goal of providing evidence-based recommendations for optimizing platelet antibody detection protocols and transfusion strategies. Methods A total of 29 782 patients were enrolled in this study, who had undergone platelet antibody testing at Zhujiang Hospital of Southern Medical University between March 2023 and April 2025. Platelet antibodies were detected using the solid-phase agglutination assay. We analyzed the relationships between platelet antibody production, demographic distribution, disease spectrum, and relevant laboratory indicators. Results Among the 29 782 hospitalized patients (15 353 males and 14 429 females), 864 cases tested positive for platelet antibodies, resulting in an overall positivity rate of 2.90%. Notably, the positivity rate was significantly higher in females than in males (3.37% vs. 2.46%, P<0.05). Females with a history of pregnancy had a higher positivity rate than those without (3.39% vs. 3.07%, P<0.05). Patients with a history of blood transfusions exhibited a higher positivity rate than those without (4.91% vs. 2.40%, P<0.05). Significant differences in positivity rates were observed across disease categories: immune system diseases had the highest rate, followed by hematologic diseases, with obstetric conditions ranking third ( P<0.05). The distribution of different types of pregnancy complications also varied significantly with platelet antibody positivity ( P<0.05). The results of total white blood cell (WBC) count, platelet (PLT) count, prothrombin time (PT) and hematocrit (Hct) in patients with positive platelet antibody were significantly different from those in negative patients ( P<0.05). Female sex, history of pregnancy (in females), history of blood transfusion, low PLT, and low Hct were identified as independent risk factors for platelet antibody positivity. Conclusion Patients with a history of blood transfusion, pregnancy (particularly females), and female patients showed a relatively higher platelet antibody positivity rate. Immune system disorders and hematologic diseases demonstrated markedly higher platelet antibody positivity rates compared to other disease categories. Positivity rates also increased in patients with pregnancy complications. Platelet antibody positivity was closely associated with sex, pregnancy history, transfusion history, PLT and Hct, while also showing some correlation with WBC and PT.These findings enable more precise identification of high-risk populations and optimization of transfusion strategies.

Objective To report two cases of hemolytic anemia caused by intravenous immunoglobulin (IVIG) in the newborn. Methods ABO and Rh blood grouping, three tests for hemolytic disease of the newborn, unexpected antibodies identification, and crossmatching were performed by serologic methods. Results Case 1: a neonate with severe HDN caused by anti-C and anti-D. After administration of IVIG, a IgG-A was detected in the neonate's elution fluid. Case 2: a neonate had hyperbilirubinemia due to infection. After administration of IVIG, DAT was weakly positive and IgG-A was detected in the elution fluid. The hemoglobin rose after stopped IVIG and transfused with O-type washed RBCs. Conclusion IVIG may cause hemolytic anemia in newborn. If it happens, the IVIG should be stopped and O-type washed RBCs is feasible for transfusion after compatible crossmatching.

Transfusion medicine is undergoing a significant transformation from traditional empirical medicine to modern precision medicine. This article systematically reviews the development of transfusion medicine from two dimensions: hardware (blood component research) and software (management system). The evolution encompasses three stages: the 1.0 cognitive initiation phase characterized by blood typing and whole blood transfusion, the 2.0 development phase marked by blood component preparation and standardized management, and the current 3.0 innovation phase featuring intelligence and personalization. In the 3.0 era, gene editing technology has facilitated the development of universal blood, the directed differentiation of stem cells has enabled the in vitro culture of blood cells, and the introduction of artificial intelligence has optimized transfusion decision-making and blood management. These technological innovations are driving transfusion medicine into a new era of precision medicine. This article provides an in-depth analysis of emerging technologies' applications in transfusion medicine and explores the opportunities and challenges brought by multidisciplinary integration, offering new perspectives for the future development of transfusion medicine.

Nucleated red blood cells (NRBCs) are immature precursors of red blood cells that retain their nuclei during the process of erythropoiesis. Under physiological conditions, NRBCs are predominantly present in the peripheral blood of pregnant women and neonates, while they are rarely detected in healthy adults. However, their levels in peripheral blood increase significantly under various pathological conditions, including hematological disorders, infectious diseases, and malignancies. This elevation is closely associated with adverse clinical outcomes, making NRBCs promising candidates as diagnostic biomarkers and prognostic indicators. This article aims to provide a comprehensive review of recent advances in NRBC research, with a focus on their molecular mechanisms in disease progression, as well as their potential applications in clinical diagnosis, treatment monitoring, and prognosis evaluation, thereby offering a new insight and strategy for precision medicine.

Objective This study aims to analyze the characteristics of 46 new HLA alleles identified in the Chinese indivivduals and provide insights into selecting HLA-matched donors for hematopoietic stem cell transplantation patients. Methods Based on the sequences of the new alleles obtained by PCR-SBT and group-specific allele amplification sequencing methods, we analyzed the types and positions of nucleotide mutations, amino acid substitutions and their property changes, and constructed three-dimensional structural models of the protein molecules. Results The 46 new HLA alleles include 11 HLA-A, 13 HLA-B, 13 HLA-C, 3 HLA-DRB1 and 6 HLA-DQB1 loci. There are 57 base mutations, of which 53 are point mutations,3 are nucleotide deletions, and 1 is a nucleotide insertion. The amino acid mutations include both synonymous mutations (12) and missense mutations (40), as well as frameshift mutations (4). Of the amino acid substitutions, 22 did not alter the nature of the amino acids, while the remaining 30 resulted in different changes in amino acid properties. Mutations in HLA class Ⅰ molecules mostly occurred in the extracellular regions, including the α1 domain (13), α2 domain (11), and α3 domain (15), with a few in the transmembrane region (4), cytoplasmic region (1), and 1 in the leader sequence. All mutations in HLA class Ⅱ molecules occurred in the extracellular regions, including the β1 domain (9) and β2 domain (2). The three new alleles with deletion mutations resulted in premature termination of protein translation.The nucleotide sequences of the four new alleles with multiple base mutations were searched and aligned in the EMBL-EBI database to analyze whether the mutations might have been generated through gene conversion. Conclusion Our analysis of these new alleles demonstrates the different mechanisms that may contribute to the evolution of HLA polymorphism. These findings will help clinicians identify HLA-matched donors for hematopoietic stem cell transplantation patients and improve the success rate of matching.

Objective To estimate the probability of RhCE antigen mismatch in random blood transfusions and establish a RhCE typing strategy suitable for patients in China. Methods The RhCE antigen mismatch between donor and recipient were determined by Landsteiner's rule. The calculation of mismatch probability and the chance of finding a matching donor were determined by the genetic parameters of Rh blood type in Chinese individuals. Results The Rh antigen distribution data of 1.04 million subjects were analyzed according to their place of origin and ethnicity. In northerners and southerners, the probabilities of RhD antigen mismatch in random blood transfusions, were 0.45% and 0.39%, respectively; The probabilities of RhCE antigen mismatch were antigen 26.31% and 23.60%, respectively; and the probability of RhCE antigen mismatch were 58.73 and 60.75 times higher than those of RhD antigen mismatch, respectively; DCCee is a high-risk phenotype for mismatching, accounting for 56.01% to 62.33% of all mismatching. A blood bank with about 100 donors can provide RhCE antigen-matched blood to 98% of Chinese patients. Conclusion In patients receiving RhD matched blood transfusions, the probability of RhCE antigen mismatch is approximately 25%. The establishment of a RhCE antigen matching strategy suitable for Chinese patients will help optimize individualized and precise blood transfusion.

Objective To construct and validate a prediction model for severe hyperbilirubinemia complicating ABO hemolytic disease of the fetus and newborn (ABO-HDNF), providing a basis for timely clinical intervention. Methods Weretrospectively analyzed clinical data from 306 ABO-HDNF infants diagnosed and treated between January 2022 and December 2024. Of these, 204 cases were regarded as the modeling set and 102 the validation set. Patients were stratified into severe and non-severe hyperbilirubinemia groups. Risk factors for severe hyperbilirubinemia were identified through univariate analysis and binary logistic regression. A nomogram model was constructed, with receiver operating characteristic (ROC) and calibration curves evaluating its performance. Clinical utility of the model was further evaluated using a clinical decision curve. Results Univariate and binary logistic regression analyses identified postnatal time at admission ( OR=1.303), positive Direct Antiglobulin Test ( OR=3.073), eluate agglutination strength ( OR=3.189), and total bilirubin/albumin ratio ( OR=1.863) as independent risk factors for severe hyperbilirubinemia ( P<0.05). The nomogram demonstrated a C-index of 0.790 (95% CI: 0.713~0.867). Area under the curve (AUC) values were 0.790 (95% CI: 0.713~0.867) and 0.754 (95% CI: 0.638~0.871) for modeling and validation sets, respectively. Calibration curves indicated good consistency, and decision curve analysis showed high net clinical benefit. Conclusion The nomogram incorporating postnatal time, Direct Antiglobulin Test results, eluate agglutination strength, and total bilirubin/albumin ratio exhibits favorable predictive performance for severe hyperbilirubinemia complicating ABO-HDNF.

Preoperative anemia occurs in 10% to 30% of adult patients undergoing cardiac surgery, leading to a range of adverse postoperative outcomes. Evidence suggests that implementing targeted management strategies for preoperative anemia can effectively reduce the risk of complications, including postoperative infections, organ dysfunction, and mortality. Current clinical practice presents a diverse array of intervention strategies; however, their efficacy and safety remain to be subjects of ongoing debate. This article systematically reviews the pathophysiological mechanisms underlying preoperative anemia and summarizes the effectiveness and limitations of common interventions such as iron supplementation, erythropoietin administration, and protocols for vitamin B ₁₂ and folic acid supplementation, Additionally, it introduces several novel therapeutic approaches for anemia, and provides an overview of comprehensive Patient Blood Management (PBM). Our aim is to offer a reference for personalized clinical management and further research on preoperative anemia.

Objective To examine the serological features of a rare case of ABO blood type mosaicism and investigate the appropriate gene sequencing methodologies. Methods Serological tests, Sanger sequencing, and PacBio gene sequencing were used to identify the ABO blood type in a hospitalized patient exhibiting discrepancies in forward and reverse typing. Results Micro-column gel card retesting for forward typing showed double cell populations (DCP) with anti-A reagent and a negative result with anti-B reagent, while reverse typing confirmed type "A". Rh blood group antigens D, C, c, E, and e were not detected as DCP. Using the tube method, the patient's red blood cells (RBCs) showed "2+ ^w" agglutination with anti-H reagent, whereas no agglutination was observed with anti-A reagent, but a "4+" reaction was seen with anti-H, indicative of a notable difference compared to the gel method. Sanger sequencing yielded inconsistent results acroos the two tests, revealing two different haplotypes: ABO*O.01.01/ABO*O.01.01 and ABO*A1.02/ABO*O.01.01. PacBio sequencing identified a primary haplotype of ABO*O.01.01/ABO*O.01.01 with approximately 400 reads, along with a haplotype of ABO*A1.02, amounting to about 40 reads. Conclusion Serological tests may fail to identity ABO blood type chimerism, and Sanger sequencing and genotyping may not detect mosaicism. However, PacBio third-generation sequencing offers a more accurate method for identifying ABO blood type and quantifying the proportions of haplotypes in chimeric or mosaic blood types.

Objective To investigate the clinical application of fresh frozen plasma (FFP) in pediatric patients with sepsis and its association with prognosis. Methods A retrospective analysis was conducted on 262 pediatric patients with sepsis admitted to the PICU of Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology between January 2023 and December 2024. Patients were categorized into an FFP transfusion group and a non-transfusion group based on whether they received FFP during hospitalization. Differences in characteristics, laboratory findings, clinical interventions, and prognostic outcomes between the two groups were compared. Results Significant differences were observed between the transfusion group ( n=87) and the non-transfusion group ( n=175) in laboratory parameters, including white blood cell count ( P=0.007), platelet count ( P=0.000), coagulation function ( P=0.000), clinical interventions ( P=0.000), and prognosis ( P=0.000). Multivariate binary logistic regression analysis revealed that FFP transfusion (HR 6.079, 95% CI 1.336-27.661, P=0.020), mechanical ventilation (HR 16.107, 95% CI 4.637-55.949, P=0.000), and PRISM Ⅲ score≥15 (HR 7.865, 95% CI 1.539-40.208, P=0.013) were independent predictors of in-hospital mortality in pediatric patients with sepsis. Additionally, FFP transfusion (HR 3.242, 95% CI 1.277-8.227, P=0.013), lactate dehydrogenase levels (HR 1.001, 95% CI 1.000-1.002, P=0.018), and PRISM Ⅲ score≥15 (HR 5.308, 95% CI 1.420-19.840, P=0.013) were identified as independent predictors of multiple organ dysfunction syndrome (MODS). Except for children over 10 years old, the transfusion group exhibited significantly higher mortality and MODS rates across all age groups (all P<0.05). Notably, children receiving FFP doses>60 mL/kg, frequency>3 times, or FFP infusion within 24 hours demonstrated the highest mortality and MODS rates. Conclusion FFP transfusion is significantly associated with increased in-hospital mortality and MODS occurrence in pediatric patients with sepsis, suggesting that clinicians should evaluate the necessity of FFP administration to reduce its irrational use.

Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) is a condition characterized by the immune-mediated destruction of fetal platelets, which occurs when IgG-specific antibodies from the mother cross the placenta. This process leads to thrombocytopenia in the fetus and/or neonate, giving rise to adverse pregnancy outcomes such as purpura, bruising, intracranial hemorrhage, and even intrauterine fetal death. In Caucasians, the primary antibody responsible for FNAIT is HPA1a antibody, whereas in Asian populations, antibodies such as anti-HPA3a, anti-HPA15, and anti-CD36 may also play a role. Notably, some of these antibodies not only target platelets but also impair placental trophoblast cells, thereby increasing the risk of severe adverse pregnancy outcomes. This review aims to summarize the epidemiology, pathogenesis, clinical features, prevention strategies, and treatment options for FNAIT.

Objective To investigate the patterns and characteristics of hemoglobin (Hb) levels in different populations under high-altitude hypoxic conditions. Methods This study included 263 healthy adults divided into three groups: (1) Native Tibetan group ( n=160): aged 18~65 (mean 38.3±13.0) years, residing at≥3 000 meters; (2) Long-term high-altitude Han Chinese group ( n=50): aged 18~65 (41.0±7.5) years, residing at≥3 000 meters for≥10 years; (3) Acute High-Altitude Group ( n=53): Age 18~36 (23.9±4.4) years, long-term residence in lowland areas (baseline altitude≤50 meters, mean 43.5 meters) with no prior high-altitude exposure. The native and long-term resident groups underwent a single cross-sectional assessment at their high-altitude locations. The Rapid Altitude Group employed a longitudinal study design: baseline measurements were taken at low altitude one week prior to high-altitude exposure (≥3 000 m), with repeated measurements conducted on days 3, 7 and 30 post-exposure. Statistical analysis of complete blood counts compared Hb levels between native Tibetans and long-term Han residents under identical high-altitude steady-state conditions to elucidate the influence of genetic factors on Hb homeostasis regulation. Hb levels were compared between baseline (lowland) and various high-altitude time points to observe acute mountain sickness and early acclimatization processes. Results 1) Hb levels in both male and female indigenous Tibetans were lower than those in long-term high-altitude Han Chinese [Males: (177±24) g/L vs. (203±23) g/L, P<0.01; females: (143±21) g/L vs. (156±24) g/L, P<0.05]; 2) The mean hemoglobin (Hb) level of Tibetan on the plateau in the 18~50-year-old age group was significantly lower than that of Han Chinese who had lived on the plateau for a long time [18~30 years: (157±26) g/L vs. (187±18) g/L, P=0.023; 30~40 years: (153±30) g/L vs. (178±33) g/L, P=0.003; 40~50 years: (156±33) vs. (178±36) g/L, P=0.022). Hemoglobin levels among Tibetan populations permanently residing at high altitudes were concentrated in the ranges of 140~150 g/L (20.63%) and 160~170 g/L (14.38%); among Han populations long-term residing at high altitudes, extremely high hemoglobin values (>200 g/L) accounted for 22%. 3) Hb levels in acutely acclimated populations exhibited a increase with time spent at altitude (7-day mean: 170 vs. baseline 152 g/L, Δ+11.2% increase at 7 days, Δ+4.7% at 30 days, P<0.001). Conclusion Hemoglobin levels serve as a sensitive physiological indicator of high-altitude adaptation across different populations, exhibiting polymorphic distribution patterns among distinct groups.

Platelet is one of the important components involved in the hemostatic process of the body, and chemotherapy-induced thrombocytopenia is one of the common side effects in the treatment of tumor patients. If PLT count cannot be recovered to 100×109/L, the next chemotherapy course often has to be interrupted, which seriously affects the therapeutic benefit. When the more severe grade 3~4 thrombocytopenia occurs, patients are at risk of severe bleeding, even life-threatening. Transfusion of apheresis platelets, human recombinant interleukin-11, and thrombopoietin have been widely used in the treatment of chemotherapy-induced thrombocytopenia, but the effectiveness of these strategies is not effective due to the patients' own underlying conditions. In this article, we review the latest clinical status, mechanism, and therapeutic benefits of chemotherapy-induced thrombocytopenia in recent years, we hope to explore more updated prevention and treatment techniques and measures.

Objective To explore the effects of high-frequency plateletpheresis on bone metabolism markers and bone mineral density (BMD) in donors. Methods (1) Twenty-one donors were enrolled and completed 30 plateletpheresis procedures within a 2-year timeframe. Specimens were collected at the 1 st, 10th, 20th, and 30th donations, with sampling time points including pre-donation, during donation, 1 hour post-donation, and 24 hours post-donation. (2) Fifty donors with ≥10 plateletpheresis sessions and over 70 cumulative apheresis procedures, together with 50 whole blood donors in the past two years, were recruited. Specimens were collected prior to donation to detect baseline levels of calcium (Ca), intact parathyroid hormone (iPTH), osteocalcin (OST/OC), C-terminal telopeptide of type I collagen (CTX-Ⅰ, β-crosslaps), and 25-hydroxyvitamin D [25-(OH)D]. The OST/CTX-Ⅰ ratio was calculated to evaluate the dominant direction of bone turnover. (3) Twenty-six donors with ≥10 plateletpheresis sessions and more than 80 cumulative apheresis procedures, as well as 24 healthy physical examination participants, underwent BMD measurement. BMD was assessed by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and hip joints. Results (1) Significant differences in Ca levels in 30 plateletpheresis donors were noted among different donation frequencies and sampling time points. The levels of iPTH, OST, CTX-Ⅰ, OST/CTX-Ⅰ ratio, and 25-(OH)D differed significantly across various sampling time points ( P<0.05). A negative correlation was found between Ca and iPTH, while positive correlations existed between iPTH and OST, and between OST and CTX-Ⅰ (all P<0.05). (2) Donors with over 70 cumulative apheresis procedures (≥10 times annually) had lower baseline serum Ca levels and higher OST and CTX-Ⅰ levels compared with blood donors ( P<0.05). (3) Donors with over 80 cumulative apheresis procedures (≥10 times annually) showed lower lumbar spine BMD than the healthy non-donors ( P<0.05), whereas no statistically significant difference in hip BMD was detected between the two groups (P>0.05). Conclusion High-frequency plateletpheresis can alter bone metabolism and BMD, accelerate bone metabolism, and render bone formation the dominant process during donation. As the total number and frequency of donations rise, it is essential to strengthen targeted guidance and health education for donors, and intensify monitoring (e.g., detection of bone metabolism markers, BMD) to better protect donor safety.

Immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by peripheral thrombocytopenia and a bleeding tendency. Its pathogenesis is mainly attributed to autoantibody-mediated platelet destruction and suppression of megakaryocyte function. Recent studies have further highlighted the contribution of platelet desialylation to antibody-mediated platelet clearance. As an important pathological indicator, platelet antibody testing plays an increasingly critical role in the auxiliary diagnosis and differential diagnosis of ITP, as well as in evaluating disease activity, monitoring treatment response, and guiding transfusion or pregnancy management. This review systematically reviews the principles and analytical performance of commonly used platelet antibody detection methods, including the monoclonal antibody immobilization of platelet antigens (MAIPA) assay, enzyme-linked immunosorbent assay (ELISA), flow cytometry, and bead-based immunoassays. We also discuss the clinical relevance of platelet antibody profiles in relation to disease phenotype and therapeutic outcomes, together with recent advances in the understanding of platelet desialylation. These findings provide a foundation for further research and may contribute to improving diagnostic strategies and clinical management in ITP.