First results of a ferritin‐based blood donor deferral policy in the Netherlands

Vinkenoog, Marieke; Hurk, Katja van den; Kraaij, Marian van; Leeuwen, Matthijs van; Janssen, Mart P.

doi:10.1111/trf.15906

Cited by 38 publications

(69 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While we did not investigate the impact of the new policy on ferritin levels or health among donors, our results suggest the new policy is successful in reducing the deferral rate for low hemoglobin levels. In accordance with previous research, donors in our ferritin categories had fewer deferrals for low hemoglobin in the follow‐up period 12 . However, the difference in duration of deferrals (standard periods ranging from 3 months for low hemoglobin to 12 months for ferritin <15 ng/mL) may have played a role in the reduction of deferrals during the follow‐up period.…”

Section: Discussionsupporting

confidence: 90%

“…When introducing new policies such as the ferritin monitoring policy, consequences can be far‐reaching and evaluation is necessary. Vinkenoog and colleagues 12 show promising results of the policy for donor ferritin levels and postulate two other important evaluation criteria: the effect on donor health and on the blood supply. While further research on the effect of the new policy on ferritin levels and donor health is being conducted, 11 this study investigated the effects on donor behavior and availability primarily for possible consequences of the policy for the blood supply.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with previous research, donors in our ferritin categories had fewer deferrals for low hemoglobin in the follow-up period. 12 However, the difference in duration of deferrals (standard periods ranging from 3 months for low hemoglobin to 12 months for ferritin <15 ng/mL) may have played a role in the reduction of deferrals during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Whole blood donor behavior and availability after deferral: Consequences of a new ferritin monitoring policy

2020

View full text Add to dashboard Cite

Background To prevent (negative consequences of) temporary deferral due to low hemoglobin, the Dutch national blood service Sanquin introduced a ferritin monitoring policy in 2017. Ferritin is measured after the donation (as opposed to before donation for hemoglobin), and low ferritin levels lead to deferral of 6 (ferritin 15‐30 ng/mL) or 12 months (ferritin <15 ng/mL). We explored the consequences of this policy on donor behavior and availability. Study Design and Methods We included all Dutch whole blood donors who made a donation (attempt) between 13 November and 31 December 2017. At that point, the ferritin monitoring policy was randomly implemented in 8 of 29 regional clusters of collection centers. We extracted information from Sanquin's donor database about donors' deferrals, subsequent donation attempts, and donation cessation (up to 31 December 2019). Donors deferred for low ferritin were compared to those deferred for low hemoglobin or other reasons, as well as to donors who were not deferred. Results A total of 55 644 donors were included (11% deferred). For donor behavior, we found that donors deferred for low ferritin less often unsubscribed and switched to other donation types, yet also made fewer donations in the follow‐up period. For availability, we found they were less often deferred, yet they were unavailable to donate for a longer period. Conclusion Results suggest that the implementation of a ferritin monitoring policy may lead to a decrease in donor availability and reduced donations. However, the policy is successful in retaining more donors and reducing low hemoglobin deferrals.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Whole blood donor behavior and availability after deferral: Consequences of a new ferritin monitoring policy

2020

View full text Add to dashboard Cite

show abstract

“…Blood services in several countries (eg, France, Denmark and Germany) have recently adopted the “post donation” approach due to its practical advantages, that is, it replaces the need for rapid on‐site testing by using a haematology analyser at a central laboratory to measure venous blood taken from the donor's sample pouch 15,27,28 . Some blood services have started to supplement a post‐donation approach with monitoring of serum ferritin, a measure of the body's iron stores, in selected blood donors 29‐31 . Future work will seek to investigate the safety, cost‐effectiveness, and practicability of the “post donation” approach in large, high‐throughput blood services such as in England.…”

Section: Discussionmentioning

confidence: 99%

Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study

Bell

Sweeting

Ramond

et al. 2020

Transfusion Medicine

View full text Add to dashboard Cite

Objective To compare four haemoglobin measurement methods in whole blood donors. Background To safeguard donors, blood services measure haemoglobin concentration in advance of each donation. NHS Blood and Transplant's (NHSBT) customary method have been capillary gravimetry (copper sulphate), followed by venous spectrophotometry (HemoCue) for donors failing gravimetry. However, NHSBT's customary method results in 10% of donors being inappropriately bled (ie, with haemoglobin values below the regulatory threshold). Methods We compared the following four methods in 21 840 blood donors (aged ≥18 years) recruited from 10 NHSBT centres in England, with the Sysmex XN‐2000 haematology analyser, the reference standard: (1) NHSBT's customary method; (2) “post donation” approach, that is, estimating current haemoglobin concentration from that measured by a haematology analyser at a donor's most recent prior donation; (3) “portable haemoglobinometry” (using capillary HemoCue); (4) non‐invasive spectrometry (using MBR Haemospect or Orsense NMB200). We assessed sensitivity; specificity; proportion who would have been inappropriately bled, or rejected from donation (“deferred”) incorrectly; and test preference. Results Compared with the reference standard, the methods ranged in test sensitivity from 17.0% (MBR Haemospect) to 79.0% (portable haemoglobinometry) in men, and from 19.0% (MBR Haemospect) to 82.8% (portable haemoglobinometry) in women. For specificity, the methods ranged from 87.2% (MBR Haemospect) to 99.9% (NHSBT's customary method) in men, and from 74.1% (Orsense NMB200) to 99.8% (NHSBT's customary method) in women. The proportion of donors who would have been inappropriately bled ranged from 2.2% in men for portable haemoglobinometry to 18.9% in women for MBR Haemospect. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% in men for NHSBT's customary method to 20.3% in women for OrSense. Most donors preferred non‐invasive spectrometry. Conclusion In the largest study reporting head‐to‐head comparisons of four methods to measure haemoglobin prior to blood donation, our results support replacement of NHSBT's customary method with portable haemoglobinometry.

show abstract

“…15,26,27 Some blood services have started to supplement a post-donation approach with monitoring of serum ferritin, a measure of the body’s iron stores, in selected blood donors. 28-30 Future work will seek to investigate the safety, cost-effectiveness, and practicability of the “post donation” approach in large, high-throughput blood services such as in England.…”

Section: Discussionmentioning

confidence: 99%

Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): a diagnostic accuracy study

Bell

Sweeting

Ramond

et al. 2020

Preprint

View full text Add to dashboard Cite

SUMMARYObjectiveTo compare four haemoglobin measurement methods in whole blood donors.BackgroundTo safeguard donors, blood services measure haemoglobin concentration in advance of each donation. NHS Blood and Transplant’s (NHSBT) usual method has been capillary gravimetry (copper sulphate), followed by venous HemoCue® (spectrophotometry) for donors failing gravimetry. However, gravimetry/venous HemoCue® results in 10% of donors being inappropriately bled (i.e., with haemoglobin values below the regulatory threshold).MethodsThe following were compared in 21,840 blood donors (aged ≥18 years) recruited from 10 mobile centres of NHSBT in England, with each method compared with the Sysmex XN-2000 haematology analyser, the reference standard: 1) gravimetry/venous HemoCue®; 2) “post donation” approach, i.e., estimating current haemoglobin concentration from that measured by a haematology analyser at a donor’s most recent prior donation; 3) capillary HemoCue®; and 4) non-invasive spectrometry (MBR Haemospect® or Orsense NMB200®). We assessed each method for sensitivity; specificity; proportion of donors who would have been inappropriately bled, or rejected from donation (“deferred”) incorrectly; and test preference.ResultsCompared with the reference standard, the methods ranged in test sensitivity from 17.0% (MBR Haemospect®) to 79.0% (HemoCue®) in men, and from 19.0% (MBR Haemospect®) to 82.8% (HemoCue®) in women. For specificity, the methods ranged from 87.2% (MBR Haemospect®) to 99.9% (gravimetry/venous HemoCue®) in men, and from 74.1% (Orsense NMB200®) to 99.8% (gravimetry/venous HemoCue®) in women. The proportion of donors who would have been inappropriately bled ranged from 2.2% in men for HemoCue® to 18.9% in women for MBR Haemospect®. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% in men for gravimetry/venous HemoCue® to 20.3% in women for OrSense®. Most donors preferred non-invasive spectrometry.ConclusionIn the largest study reporting head-to-head comparisons of four methods to measure haemoglobin prior to blood donation, our results support replacement of venous HemoCue® with the capillary HemoCue® when donors fail gravimetry. These results have had direct translational implications for NHS Blood and Transplant in England.

show abstract

First results of a ferritin‐based blood donor deferral policy in the Netherlands

Cited by 38 publications

References 18 publications

Whole blood donor behavior and availability after deferral: Consequences of a new ferritin monitoring policy

Whole blood donor behavior and availability after deferral: Consequences of a new ferritin monitoring policy

Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study

Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): a diagnostic accuracy study

Contact Info

Product

Resources

About