Assessment of Serum Ferritin Levels in Plateletpheresis Donors

Abstract

Background: While plateletpheresis donation results in less red blood cell loss and therefore less depletion of storage iron, repeated plateletpheresis can also lead to iron depletion. To determine the safety of regular plateletpheresis donations, this study estimated donor's iron status according to age, gender, number of donations, and donation interval. Methods: The study population included 5,109 plateletpheresis donors (4,824 males, 285 females), who passed the hemoglobin (Hb) criteria for plateletpheresis donation of 12.0 g/dL or more in an inclusion period (September 2013∼November 2013). During donor screening, serum ferritin levels were measured for assessment of iron status of plateletpheresis donors. Results: Mean age of donors was 30.4 years (range: 17∼59). Donors with a history of donation of more than 3 years accounted for 89.3% and 74.0% in males and females, respectively. Mean donation interval and annual donation number in male (female) donors was 11.9 (7.2) weeks and 4.2 (8.7) times, respectively. Approximately 37.8% of male donors and 64.2% of female donors had a serum ferritin level of less than 15 ng/mL. Serum ferritin levels showed correlation with donation interval, as the percentage of donors with a low ferritin level decreased with increase in donation interval (: 0.191∼0.438, P＜0.001). Serum ferritin levels also showed correlation with annual plateletpheresis number (: -0.261∼-0.411, P＜0.001). Conclusion: Depleted iron store was observed in nearly 40% of donors who had acceptable Hb levels for plateletpheresis donation. Hb pre-donation screening is not sufficient to reduce the risk of iron deficiency in regular plateletpheresis donors. (Korean J Blood Transfus 2015;26:282-290)

Prevalence, risk factors, and ferritin testing to mitigate iron depletion in male plateletpheresis donors

“…14,15 Finally, in a study of 5000 Korean donors, 38% of male and 64% of female plateletpheresis donors had ferritin levels less than 15 ng/mL, but this study did not control for whole blood donation nor, like the other cited studies, did it perform multivariable analysis. 13 By performing multivariable regression that quantified separately RBC loss from platelet and whole blood donations, we refine the earlier studies and confirm the ability of platelet donation to sustain and potentially to create iron depletion in blood donors, even at relatively low donation frequency. This study enhances our understanding of options for mitigating iron depletion in blood donors, specifically the potential impact on product availability under ferritin testing.…”

“…In the United States and Ireland, small pilot studies in male donors similarly suggested a risk for iron depletion from frequent apheresis donation . Finally, in a study of 5000 Korean donors, 38% of male and 64% of female plateletpheresis donors had ferritin levels less than 15 ng/mL, but this study did not control for whole blood donation nor, like the other cited studies, did it perform multivariable analysis . By performing multivariable regression that quantified separately RBC loss from platelet and whole blood donations, we refine the earlier studies and confirm the ability of platelet donation to sustain and potentially to create iron depletion in blood donors, even at relatively low donation frequency.…”

“…[2][3][4][6][7][8][9] Though regulatory interest and communications from the AABB (providing blood collector accreditation in the United States and internationally) have focused on whole blood donors, 10,11 a number of recent, mostly pilot studies have shown plateletpheresis donors to have elevated risk for iron depletion. 4,[12][13][14][15][16] There are multiple reasons why plateletpheresis donors could have an appreciable risk for iron depletion. Many plateletpheresis donors have a history of whole blood or RBC apheresis donation, so they might start their platelet donation career with already diminished iron stores.…”

“…Other countries have also documented frequent iron depletion, and risk factors reported from most studies include young donor age, female sex, and regular blood donation . Though regulatory interest and communications from the AABB (providing blood collector accreditation in the United States and internationally) have focused on whole blood donors, a number of recent, mostly pilot studies have shown plateletpheresis donors to have elevated risk for iron depletion …”

Frequent source plasma donors are not at risk of iron depletion: the Ferritin Levels in Plasma Donor (FLIPD) study

“…The last measure has been shown in controlled clinical trials to protect frequent blood donors from iron depletion with the result that both anemia and nonanemic consequences of iron depletion are prevented . Iron depletion has also been reported in apheresis donors, particularly platelet apheresis donors . In the face of increasing attention to this problem by community blood centers and regulatory authorities, we believe our data are important and provide evidence that no further action by SP donor centers is needed to ensure adequate iron stores.…”