Blood donor iron status

Spencer, Bryan R.

doi:10.1097/moh.0b013e32836589f2

Cited by 24 publications

(9 citation statements)

References 28 publications

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“…Eligibility for blood donation is usually tested using Hb as a marker since it is available as a point‐of‐care test. However, it has been established in several studies that Hb is a poor indicator of iron status and may not show a decline till the iron stores have been completely depleted [11–13]. The present minimum Hb requirement of 12.5 g/dL serves to prevent the development of anaemia but, on the contrary, does not accurately mitigate the development of ID [14].…”

Section: Discussionmentioning

confidence: 99%

‘Ironing out the risk’: Assessing the effect of plateletpheresis donation frequency on iron stores in South‐Asian male donors

Madkaiker,

Hiregoudar,

Chavan

et al. 2023

Vox Sanguinis

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Background and ObjectivesRepeated blood donation is a well‐known cause of iron deficiency among donors. However, present scientific literature lacks comprehensive evidence regarding the impact of regular plateletpheresis procedures on body iron reserves. In this study, we aimed to detect and correlate iron deficiency (using iron indices) with the frequency of platelet donations. Additionally, we also analysed the correlation between other iron and haematological indices with serum ferritin to determine cost‐effective parameters that may serve as an initial screening approach to determine which donors should be subjected to serum ferritin testing.Materials and MethodsA total of 180 male participants from our platelet donor registry were enrolled in this observational cross‐sectional study. Enrolment questionnaires were administered to eligible donors, and biological samples were collected during plateletpheresis donation. Biological tests such as complete blood count, reticulocyte indices, iron indices, vitamin B12 and folate were performed.ResultsDonors with ≥12 donations per year showed the highest prevalence of low ferritin (serum ferritin: 15–30 ng/mL) and absent iron stores (serum ferritin <15 ng/mL) (41.3% and 26.7%, respectively). Ferritin showed a significant negative correlation with recent (r = −0.346) and lifetime donations (r = −0.196). The efficacy of other indices for identifying iron depletion was much better using a serum ferritin value <15 ng/mL.ConclusionRegular plateletpheresis donations can lead to varying severities of non‐anaemic iron deficiency. Blood centres must regularly monitor frequent plateletpheresis donors (especially donors with more than 11 donations in a calendar year) and ideally maintain their serum ferritin above 30 ng/mL.

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Section: Discussionmentioning

confidence: 99%

‘Ironing out the risk’: Assessing the effect of plateletpheresis donation frequency on iron stores in South‐Asian male donors

Madkaiker,

Hiregoudar,

Chavan

et al. 2023

Vox Sanguinis

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“…Among new donors, large variation in ferritin levels is observed 4 . It is well established that individual characteristics such as sex and age are relevant: women in general, but pre‐menopausal women in particular, have considerably lower ferritin levels than men 4,6,7 . Higher body mass index (BMI) is associated with higher ferritin levels 8 .…”

Section: Introductionmentioning

confidence: 99%

“…4 It is well established that individual characteristics such as sex and age are relevant: women in general, but pre-menopausal women in particular, have considerably lower ferritin levels than men. 4,6,7 Higher body mass index (BMI) is associated with higher ferritin levels. 8 In recent decades, many other factors that affect iron status have been identified: diet, 9,10 genetics, 11,12 ethnicity, 13 and iron supplementation, which is mostly studied among blood donors.…”

Section: Introductionmentioning

confidence: 99%

Individual and environmental determinants of serum ferritin levels: A structural equation model

Vinkenoog

Groot

Lakerveld

et al. 2022

Transfusion Medicine

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Background and Objectives: Serum ferritin levels are increasingly being used to assess iron stores. Considerable variation in ferritin levels within and between individuals has been observed, but our current understanding of factors that explain this variation is far from complete. We aim to combine multiple potential determinants in an integrative model, and investigate their relative importance and potential interactions. Methods: We use ferritin measurements collected by Sanquin Blood Bank on both prospective (N = 59 596) and active blood donors (N = 78 318) to fit a structural equation model with three latent constructs (individual characteristics, donation history, and environmental factors). Parameters were estimated separately by sex and donor status.Results: The model explained 25% of ferritin variance in prospective donors, and 40% in active donors. Individual characteristics and donation history were the most important determinants of ferritin levels in active donors. The association between environmental factors and ferritin was smaller but still substantial; higher exposure to air pollution was associated with higher ferritin levels, and this association was considerably stronger for active blood donors than for prospective donors.Discussion: In active donors, individual characteristics explain 20% (17%) of ferritin variation, donation history explains 14% (25%) and environmental factors explain 5% (4%) for women (men). Our model presents known ferritin determinants in a broader perspective, allowing for comparison with other determinants as well as between new and active donors, or between men and women.

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“…As a result of one donation, whole blood donors lose 8% (men) to 81% (menstruating women) of their total iron stores [ 1 – 3 ]. High donation frequency increases the risk for depleted iron stores through the haemoglobin (Hb)-bound iron loss and subsequent increased erythropoiesis [ 4 , 5 ]. Depletion of iron stores, iron-deficient erythropoiesis and iron-deficiency anaemia may not only negatively influence donor health [ 6 ], but may also lead to a higher risk of low-Hb deferral [ 7 ], which is demotivating for a blood donor and costly for blood banks [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Ferritin measurement IN Donors—Effectiveness of iron Monitoring to diminish iron deficiency and low haemoglobin in whole blood donors (FIND’EM): study protocol for a stepped wedge cluster randomised trial

Sweegers

Zalpuri

Quee

et al. 2020

Trials

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Background Blood donors are at risk for reduced iron stores, because of which donor iron monitoring received increased attention in the last decade. Despite the importance for donor health, international consensus on an appropriate policy for iron monitoring is lacking. Therefore, we conduct a trial to evaluate to what extent ferritin-guided donation intervals are effective in increasing haemoglobin and ferritin levels, decreasing low-haemoglobin deferral, increasing donor return and improving the health of whole blood donors in the Netherlands. Methods Sanquin Blood Bank is implementing ferritin-guided donation intervals to prevent donors from increasing iron loss at repeated donations. Using a stepped wedge cluster randomised trial approach, the design involves a random crossover of 29 clusters of blood collection centres from the existing policy without ferritin measurements to a ferritin-guided donation interval policy. This new policy includes ferritin measurements for all new donors and at every 5th whole blood donation, extending donation intervals to 6 months if ferritin is 15–≤ 30 ng/mL and to 12 months if ferritin is < 15 ng/mL. We measure ferritin levels of whole blood donors from stored plasma samples and collect haemoglobin levels and information on low-haemoglobin deferral and donor return from the donor database before, during and after the implementation period. We measure donor health during and after the implementation period using questionnaires, assessing physical and mental wellbeing and iron deficiency- and donation-related symptoms. We use multilevel analyses to investigate differences in ferritin and haemoglobin levels, low-haemoglobin deferral rates, donor return and donor health from whole blood donors, between blood collection centres that have versus those that have not yet implemented the ferritin-guided donation interval policy. Discussion This stepped wedge cluster randomised trial will provide insight into the effectiveness of ferritin-guided donation intervals in lowering iron deficiency, decreasing donor deferrals due to low haemoglobin and improving donor health. We will evaluate a policy that is implemented nationwide in a real-life setting. Our study is therefore not limited to a small experimental setting and the results will guide policymakers seeking an appropriate policy for iron monitoring. Trial registration The Dutch trial registry NTR6738. Registered on 29 September 2017. Retrospectively registered.

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Blood donor iron status

Cited by 24 publications

References 28 publications

‘Ironing out the risk’: Assessing the effect of plateletpheresis donation frequency on iron stores in South‐Asian male donors

‘Ironing out the risk’: Assessing the effect of plateletpheresis donation frequency on iron stores in South‐Asian male donors

Individual and environmental determinants of serum ferritin levels: A structural equation model

Ferritin measurement IN Donors—Effectiveness of iron Monitoring to diminish iron deficiency and low haemoglobin in whole blood donors (FIND’EM): study protocol for a stepped wedge cluster randomised trial

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