Oral or parenteral iron supplementation to reduce deferral, iron deficiency and/or anaemia in blood donors

Abstract

BackgroundIron deficiency is a significant cause of deferral in people wishing to donate blood. If iron removed from the body through blood donation is not replaced, then donors may become iron deficient. All donors are screened at each visit for low haemoglobin (Hb) levels. However, some deferred blood donors do not return to donate. Deferred first-time donors are even less likely to return. Interventions that reduce the risk of provoking iron deficiency and anaemia in blood donors will therefore increase the number of blood donations. Currently, iron supplementation for blood donors is not a standard of care in many blood services. A systematic review is required to answer specific questions regarding the efficacy and safety of iron supplementation in blood donors. ObjectivesTo assess the efficacy and safety of iron supplementation to reduce deferral, iron deficiency and/or anaemia in blood donors. Search methodsWe ran the search on 18 November 2013. We searched Cochrane Injuries Group Specialised Register, CENTRAL, PubMed, MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL (EBSCO Host) and six other databases. We also searched clinical trials registers and screened guidelines reference lists. Selection criteriaRandomised controlled trials (RCTs) comparing iron supplementation versus placebo or control, oral versus parenteral iron supplementation, iron supplementation versus iron-rich food supplements, and different doses, treatment durations and preparations of iron supplementation in healthy blood donors. Autologous blood donors were excluded. Data collection and analysisWe combined data using random-effects meta-analyses. We evaluated heterogeneity using the I 2 statistic; we explored considerable heterogeneity (I 2 > 75%) in subgroup analyses. We carried out sensitivity analyses to assess the impact of trial quality on the results. 1 Oral or parenteral iron supplementation to reduce deferral, iron deficiency and/or anaemia in blood donors (Review)

Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women

“…3 Although both daily and intermittent supplementation can replete iron stores and increase hemoglobin levels, 4 iron supplements often cause gastric irritation, nausea, epigastric discomfort, and constipation, which may decrease compliance and long-term efficacy. 5 The absorption of iron supplements ranges from 2% to 13% and 5% to 28% in subjects with low iron stores 6 when consumed with and without food, respectively. Thus, a majority of the iron is unabsorbed.…”

Effect of iron supplementation on iron stores and total body iron after whole blood donation

“…1,2 A number of studies have demonstrated that iron supplementation can reverse the iron depletion and reduce hemoglobin deferrals associated with blood donation. 3,4 Our group has recently documented that use of daily iron supplements is necessary for efficient recovery of donor hemoglobin and iron to support blood donation. 5 To date studies have separately assessed the effect of blood donation on iron stores, as assessed by serum or plasma ferritin, and hemoglobin, as assessed by venous hemoglobin concentrations.…”

Iron Supplements and Iron Status in Frequent Blood Donors

“…2,10 Iron supplements are required for iron replacement due to blood loss from a donation. [15][16][17][18] Thus, all donors in this study were given iron supplements after their blood donation. The difference in dose intake of each donor may be a factor that affects the ferritin level; however, ferritin itself was an acute phase reactant, 19,20 which may increase if donors were in or recently passed the inflammatory stage and the exact dose of iron supplements in each donor was not known.…”