Utility of zinc protoporphyrin in management of whole blood donors

Schotten, Nienke; Zalpuri, Saurabh; Jong, P.C.M. Pasker-de; Swinkels, Dorine W.; Hurk, Katja van den; Kort, Wim de; Kraaij, M.G.J. van; Noord, P.A.H. van

doi:10.1111/trf.14480

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…transferrin saturation, ferritin, soluble transferrin receptor (sTfR), sTfR/ferritin ratio, zinc protoporphyrin, red blood cell indices) [11,39]. Zinc protoporphyrin, in addition to haemoglobin measurements, has been proposed to add to the identification of low iron stores [40]. Zinc protoporphyrin is formed when zinc instead of iron is used in heme synthesis in the case of insufficient iron availability [41].…”

Section: Measurement Of Ferritin Levelsmentioning

confidence: 99%

“…Zinc protoporphyrin is formed when zinc instead of iron is used in heme synthesis in the case of insufficient iron availability [41]. Zinc protoporphyrin is therefore an indicator of iron-deficient erythropoiesis to identify donors at risk for developing iron-deficiency anaemia, but the measurement is not always easy to perform and lacks standardization [40]. The measurement of plasma ferritin has been proposed as the most useful value in monitoring blood donors' iron stores and an increasing number of blood collection centres are measuring ferritin in whole blood donors [13].…”

Section: Measurement Of Ferritin Levelsmentioning

confidence: 99%

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First do no harm: iron loss in whole blood donors

Sweegers

Kraaij

Hurk

2019

ISBT Science Series

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Frequent whole blood donations are known to be related to iron deficiency, potentially leading to donor deferral and iron deficiency-related symptoms. To ensure that blood donation causes no harm to the donor, it is of importance for blood collection centres to gain insight in whole blood donors' iron status, how that affects donor health and by what means low iron stores in blood donors should be managed. Since haemoglobin levels do not reflect donors' true iron status, measuring ferritin might be a better way to detect low iron stores. International consensus on an appropriate strategy for iron monitoring is currently lacking. Multiple strategies for iron monitoring of whole blood donors are available, including haemoglobin-or ferritin-guided donation intervals and iron supplementation. Studies from the USA and Denmark showed that on the introduction of ferritin-guided donation intervals or iron supplementation, deferral percentages for low haemoglobin declined in both male and female donors. However, implementing an iron monitoring strategy may introduce its own challenges in donor management and donor availability. Here, we present the prevalence and determinants of iron deficiency in blood donors and describe subgroups of donors who may be more prone to iron deficiency. Furthermore, we provide an overview of possible strategies for iron monitoring and describe challenges and implications. Possible adverse events associated with iron deficiency in whole blood donors should be further investigated to evaluate the potential harm to the donor. Evidence-based insight in measures to prevent iron deficiency could help to develop an appropriate iron monitoring strategy.

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Section: Measurement Of Ferritin Levelsmentioning

confidence: 99%

Section: Measurement Of Ferritin Levelsmentioning

confidence: 99%

First do no harm: iron loss in whole blood donors

Sweegers

Kraaij

Hurk

2019

ISBT Science Series

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“…ZPP is formed when iron levels are low and protoporphyrin binds with zinc instead. Raised levels of ZPP have long been investigated as an early marker of iron deficiency (Schotten et al, ).…”

Section: Ironmentioning

confidence: 99%

2018 European Conference on Donor Health and Management

Cho

2019

Transfusion Medicine

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Summary The third European Conference on Donor Health and Management (ECDHM) was held in Copenhagen from 5th to 7th September 2018 and was co‐organised by the ECDHM committees and European Blood Alliance. This is an international conference with a focus on ‘donor health’, including donors of blood, organs and other substances of human origin, and remains the only conference focusing exclusively on donor medicine. This overview presents a selection of research topics in relation to iron, the keynote speeches and plenary talks. The keynote speeches cover the epidemiology of donors and recipients, whole‐blood donor recruitment and retention and the safety of donors and recipients of plasma and plasma products. Talks from the plenary speakers reviewed modern multi‐omic approaches to study red cell quality and the central, perennial question of what motivates a donor to give blood and how can this be encouraged.

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“…It is therefore difficult to integrate ZnPP determination into the blood donation workflow. These reasons may explain why ZnPP is currently not used in blood donor management, despite promising results demonstrating the capability of ZnPP to identify iron-deficient donors in earlier studies [ 8 , 19 , 20 , 21 , 22 , 23 ]. The herein proposed approach to measure ZnPP overcomes the limitations of standard hematofluorometer measurements and may be easily integrated into the routine blood donation process.…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Zinc Protoporphyrin Screening Offers Opportunities for Secondary Prevention of Iron Deficiency in Blood Donors

Schliemann

Homann

Hennig

et al. 2023

Transfus Med Hemother

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Background: Frequent blood donors are at high risk of developing iron deficiency. Currently, there is no potent screening during blood donation to detect iron deficient erythropoiesis (IDE) before anemia develops and deferral from donation is inevitable. Study Design and Methods: In addition to capillary and venous hemoglobin, the iron status of 99 frequent blood donors was assessed by various venous blood parameters and zinc protoporphyrin IX (ZnPP). ZnPP was determined by high-performance liquid chromatography (HPLC) and a new prototype fiber-optic device was employed for non-invasive measurements of ZnPP through the blood collection tubing (NI-tubing) and on lip tissue (NI-lip). We aimed to evaluate the feasibility and diagnostic value of the NI-tubing measurement for early detection of severe iron deficiency in blood donors. Results: NI-tubing and HPLC reference measurements of ZnPP showed narrow limits of agreement of 12.2 μmol ZnPP/mol heme and very high correlation (Spearman’s Rho = 0.938). Using a cutoff of 65 μmol ZnPP/mol heme, NI-tubing measurements (n = 93) identified 100% of donors with iron deficiency anemia (IDA) and an additional 38% of donors with IDE. Accordingly, NI-tubing measurements would allow detection and selective protection of particularly vulnerable donors. Conclusion: NI-tubing measurements are an accurate and simple method to implement ZnPP determination into the routine blood donation process. ZnPP was able to identify the majority of subjects with IDE and IDA and might therefore be a valuable tool to provide qualified information to donors about dietary measures and adjustments of the donation interval and thereby help to prevent IDA and hemoglobin deferral in the future.

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Utility of zinc protoporphyrin in management of whole blood donors

Abstract: Our results suggest that adding ZPP to Hb measurements in the daily blood collection setting, especially for first-time donors and first-time female donors may add to the identification of a donor subpopulation with low functional iron stores.

Cited by 4 publications

References 19 publications

First do no harm: iron loss in whole blood donors

First do no harm: iron loss in whole blood donors

2018 European Conference on Donor Health and Management

Non-Invasive Zinc Protoporphyrin Screening Offers Opportunities for Secondary Prevention of Iron Deficiency in Blood Donors

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