Evaluation of donor ALT screening strategies based on random sampling simulation with large sample sizes
10.13303/j.cjbt.issn.1004-549x.2025.08.015
- VernacularTitle:基于大标本量随机抽样模拟下的献血者ALT筛查策略评估
- Author:
Liqin HUANG
1
;
Yuanye XUE
1
;
Le CHANG
2
;
Lunan WANG
2
;
Jinfeng ZENG
1
Author Information
1. Shenzhen Blood Centre, Shenzhen 518040, China
2. National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/ National Center of Gerontology, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
blood donor;
alanine aminotransferase (ALT);
detection strategy;
cost-effectiveness analysis
- From:
Chinese Journal of Blood Transfusion
2025;38(8):1094-1100
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To comprehensively evaluate the current alanine aminotransferase (ALT) screening strategies and provide a basis for their optimization. Methods: ALT test results of 21 345 blood samples were collected from 33 blood collection institutions. Multiple probability distribution functions were employed to fit the data, and the akaike information criterion (AIC) was used to determine the optimal fitting model. Based on this model, 1 million random samplings were conducted to simulate the final ALT test results of blood donors under different ALT screening strategies, eligibility criteria, and pre-donation ALT detection deviations. A decision tree was subsequently constructed for health economic analysis. Results: The log-normal distribution with a mean of 2.96 and a variance of 0.65 provided the best fit for the data. When the eligibility criteria was 50 U/L and the pre-donation detection deviation was ±20%, not conducting pre-donation testing increased blood donation by 1.14%. When the pre-donation detection deviation was ±20% and the eligibility criteria was raised from 50 U/L to 100 U/L, conducting and not conducting pre-donation testing increased blood donation by 7.59% and 6.60%, respectively. With a eligibility criteria of 50 U/L and a pre-donation detection deviation of ±20%, 1.14% of eligible blood donors would be disqualified from donating blood. Health economic analysis showed that when the eligibility criteria was adjusted to 56 U/L or higher, not conducting pre-donation ALT testing was the dominant strategy; under other conditions, conducting pre-donation testing was the dominant strategy. Conclusion: The selection of ALT testing strategies is a complex process influenced by multiple factors, and it is necessary to adopt an appropriate ALT screening strategy based on specific testing circumstances.
