從韌性醫療看國血國用與精實輸血策略【本期企劃】 試閱
Resilient Healthcare: National Blood Self-Sufficiency and Privileged Transfusion Strategies
輸血醫學是現代醫療中不可或缺的一環，無論在急診醫療、重大手術、癌症治療，甚至加護病房照護中，血液與血液製劑的使用往往攸關病人存活與康復。本文分析臺灣捐血事業的發展軌跡，從早年的「血牛時代」到1980年代逐漸建立的「無償捐血制度」，包括中華民國捐血運動協會成立、實施醫院血庫及捐血機構的評鑑作業及血液基金會成立，使血液供應走向公益化與制度化。接著，醫療財團法人台灣血液基金會積極配合政府「國血國用」政策，朝向國血製劑自給自足目標邁進，以及根據臨床醫學實證之發展，2013年實施血品全面進行核酸擴增試驗（nucleic acid amplification test, NAT），進一步提升輸血安全，並於2020年導入「病人用血管理」（patient blood management, PBM）概念，協助各醫院落實「以病人為中心」的精實輸血策略。本文也從如何強化臺灣韌性醫療的角度，對未來血液供應與輸血醫學的挑戰提出反思，盼能在「健康臺灣」願景下，建構出一個兼顧醫療品質、病人安全與醫療永續的輸血體系。
Transfusion medicine is an indispensable part of modern healthcare, encompassing emergency medicine, major surgeries, cancer treatment, and intensive care. The availability and safety of blood and blood components are often crucial to patient survival and recovery. This paper reviews the evolution of Taiwan’s blood donation system— from the early “paid blood donor era” to the establishment of the “voluntary, non-remunerated blood donation” system in the 1980s. The founding of the Taiwan Blood Services Foundation institutionalized and publicized the national blood supply system, ensuring fairness, safety, and reliability. In alignment with the National Blood Self Sufficiency Policy (NBSP), the Foundation has pursued self-sufficiency in plasma-derived medicinal products (PDMPs), while introducing the Nucleic Acid Amplification Test (NAT) in 2013 to further strengthen transfusion safety. In 2020, the Patient Blood Management (PBM) program was implemented to promote privileged transfusion and optimize blood utilization through evidence-based, patient centered approaches. From the perspective of resilient healthcare, this article reflects on the challenges and future directions of Taiwan’s blood supply and transfusion medicine under the dual pressures of population aging and declining birth rates. By integrating national policy, clinical innovation, and public participation, Taiwan continues to build a sustainable and resilient transfusion medicine system that supports the Healthy Taiwan Vision.
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