Prevalence of blood donor iron deficiency and feasibility ferritin‐based iron replacement: a blood collection agency‐based study

Gorlin, Jed B.; Katz, Louis M.; Elsmore, D; Kirbach, Kyleigh; Erickson, Yasuko; Hove, Annechien van; Black, Cheryl; Walsh-Jahnke, R

doi:10.1111/vox.12408

Cited by 21 publications

(26 citation statements)

References 8 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Actionable interventions beyond education must also be considered to protect blood donors from iron deficiency . Possibilities include extending the interdonation interval, performing ferritin testing prior to donation, and providing iron supplementation . The efficacy of these interventions is well established, and there is growing evidence to support the feasibility of implementing these interventions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study

et al. 2019

View full text Add to dashboard Cite

Background: Blood donation results in a loss of iron stores, which is particularly concerning for young female blood donors. This study examines the association of blood donation and iron deficiency among adolescent and adult females in the United States. Study design and methods: A cross-sectional analysis was performed using data from the 1999–2010 National Health and Nutrition Examination Survey. Females who reported their blood donation history in the preceding year and had serum ferritin (SF) measurements were included. Analyses were weighted and stratified by adolescents (16–19 years;n=2,419) and adults (20–49 years;n=7,228). Adjusted prevalence ratios (aPRs) were estimated by multivariable Poisson regression. Standard errors were estimated by Taylor series linearization. Results: Geometric mean SF levels (ng/mL) were lower in blood donors compared to non-donors among adolescents (21.2 vs. 31.4;p<0.001) and among adults (26.2 vs. 43.7;p<0.001). The prevalence of absent iron stores (SF<12 ng/mL) was higher in blood donors compared to non-donors among adolescents (22.6% vs. 12.2%; aPR=2.03 [95%CI=1.45–2.85]) and among adults (18.3% vs. 9.8%; aPR=2.06 [95%CI=1.48–2.88]). Additionally, the prevalence of iron deficiency anemia (SF<26 ng/mL and hemoglobin<12.0 g/dL) was also higher in blood donors compared to non-donors among adolescents (9.5% vs. 6.1%; aPR=2.10 [95%CI=1.13–3.90]) and among adults (7.9% vs. 6.1%; aPR=1.74 [95%CI=1.06–2.85]). Similar results were observed in a sensitivity analysis restricted to adolescents aged 16–18 years. Conclusions: Blood donation is associated with iron deficiency among adolescent and adult females in the U.S. These national data call for further development and implementation of blood donation practices aimed toward mitigating iron deficiency.

show abstract

Section: Discussionmentioning

confidence: 99%

“…44 Possibilities include extending the interdonation interval, 45 performing ferritin testing prior to donation, 46-50 and providing iron supplementation. 49,[51][52][53][54] The efficacy of these interventions is well established, and there is growing evidence to support the feasibility of implementing these interventions.…”

Section: Discussionmentioning

confidence: 99%

Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The authors concluded that sending donors a letter with ferritin results was somewhat less efficacious than providing iron supplements, but better than placebo. In a small study performed in two US blood centers, 200 donors were consented and had ferritin levels measured; those with low ferritin were sent their results, as well as iron supplements, and deferred for 112 days . Mean ferritin had increased from 8.7 to 24.2 µg/L in the donors with low ferritin on index donation tested a mean of 4 months later; Hb deferral rates also decreased.…”

Section: Discussionmentioning

confidence: 99%

A large national study of ferritin testing in Canadian blood donors

et al. 2016

View full text Add to dashboard Cite

The minimum hemoglobin level will be increased to 130 g/L for male donors and the minimum interdonation interval changed to 84 days (four donations yearly) for female donors based on iron deficiency risk groups. Large-scale ferritin testing was feasible. Donors informed of low-ferritin results had a lower return rate, donated less often, and had an increase in ferritin on return, approximately 1 year after initial testing, compared to donors with normal ferritin results.

show abstract

“…Hence, the lower limit for ferritin in iron-replete men and women are comparable, and support a single, unified threshold. Prospective, non-randomized studies have found that ferritin monitoring along with recommendations to delay donation, seek medical advice, and/or take iron supplements modestly reduces the frequency of anaemia, Hb deferrals and low ferritin, with some decrease in rates of donor return (O'Meara et al, 2011;Magnussen & Ladelund, 2015;Goldman et al, 2016b;Goldman et al, 2017b) and appears to be feasible (Gorlin et al, 2016). sTfR values have been used in conjunction with ferritin measurements as a ratio, log (sTfR/ferritin) (Skikne et al, 1990;Cook et al, 2003).…”

Section: Ferritinmentioning

confidence: 99%

How do we manage iron deficiency after blood donation?

Kiss

Vassallo

2018

Br J Haematol

View full text Add to dashboard Cite

Blood donors and the RBCs and other components they willingly provide are essential in the delivery of healthcare in all parts of the world. Nearly 70% of donated blood comes from repeat or committed donors. The amount of iron removed in the 10 min or so it takes to withdraw a unit of blood (500 ml, plus 25 ml for testing) requires over 24 weeks to replace on a "standard" diet, i.e., without added iron in the form of supplements The cumulative effect of repeat blood donations without adequate iron replacement or a longer wait between donations results in iron deficiency (ID) in many donors, low haemoglobin deferral (~8% of donation attempts), and frank anaemia in some. Moreover, ID can be associated with side effects that can impact a blood donor's health, such as fatigue, cognitive changes and other neuromuscular symptoms. In an effort to better identify and prevent ID, blood collection agencies are recommending various strategies, including changes in the donation interval, donation frequency, testing of iron status and iron supplementation. In this review, we present the evidence basis for these strategies and suggest our own approaches to improving iron balance in blood donors.

show abstract

Prevalence of blood donor iron deficiency and feasibility ferritin‐based iron replacement: a blood collection agency‐based study

Cited by 21 publications

References 8 publications

Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study

Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study

A large national study of ferritin testing in Canadian blood donors

How do we manage iron deficiency after blood donation?

Contact Info

Product

Resources

About