Variations in hemoglobin measurement and eligibility criteria across blood donation services are associated with differing low‐hemoglobin deferral rates: a BEST Collaborative study

Zalpuri, Saurabh; Romeijn, Bas; Allara, Elias; Goldman, Mindy; Kamel, Hany; Gorlin, Jed B.; Vassallo, Ralph R.; Grégoire, Yves; Goto, Naoko; Flanagan, Peter; Speedy, Joanna; Buser, Andreas; Kutner, José Mauro; Magnussen, Karin; Castrén, Johanna; Culler, Liz; Sussmann, Harry; Prinsze, Femmeke J.; Belanger, Kevin; Compernolle, Veerle; Tiberghien, Pierre; Cardenas, Jose M.; Gandhi, Manish J.; West, Kamille A.; Lee, Cheuk-Kwong; James, Sian; Wells, Deanne; Wendel, Silvano; Coleman, Matthew; Seltsam, Axel; Roden, Kimberly; Steele, Whitney R.; Bohoněk, Miloš; Alcantara, Ramir; Angelantonio, Emanuele Di; Hurk, Katja van den

doi:10.1111/trf.15676

Cited by 19 publications

(21 citation statements)

References 23 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Increased deferrals due to low hemoglobin/hematocrit among women can be attributed to the impact of menstruation and pregnancy which can result in lower hemoglobin and iron stores 26 . Iron supplementation has been demonstrated to reduce deferrals due to low hemoglobin among women and frequent donors 27,28 …”

Section: Discussionmentioning

confidence: 99%

Supplemental findings of the 2019 National Blood Collection and Utilization Survey

et al. 2021

View full text Add to dashboard Cite

Introduction Supplemental data from the 2019 National Blood Collection and Utilization Survey (NBCUS) are presented and include findings on donor characteristics, autologous and directed donations and transfusions, platelets (PLTs), plasma and granulocyte transfusions, pediatric transfusions, transfusion‐associated adverse events, cost of blood units, hospital policies and practices, and implementation of blood safety measures, including pathogen reduction technology (PRT). Methods National estimates were produced using weighting and imputation methods for a number of donors, donations, donor deferrals, autologous and directed donations and transfusions, PLT and plasma collections and transfusions, a number of crossmatch procedures, a number of units irradiated and leukoreduced, pediatric transfusions, and transfusion‐associated adverse events. Results Between 2017 and 2019, there was a slight decrease in successful donations by 1.1%. Donations by persons aged 16–18 decreased by 10.1% while donations among donors >65 years increased by 10.5%. From 2017 to 2019, the median price paid for blood components by hospitals for leukoreduced red blood cell units, leukoreduced apheresis PLT units, and for fresh frozen plasma units continued to decrease. The rate of life‐threatening transfusion‐related adverse reactions continued to decrease. Most whole blood/red blood cell units (97%) and PLT units (97%) were leukoreduced. Conclusion Blood donations decreased between 2017 and 2019. Donations from younger donors continued to decline while donations among older donors have steadily increased. Prices paid for blood products by hospitals decreased. Implementation of PRT among blood centers and hospitals is slowly expanding.

show abstract

Section: Discussionmentioning

confidence: 99%

Supplemental findings of the 2019 National Blood Collection and Utilization Survey

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Currently, international consensus on an appropriate policy for donor iron management is lacking [4]. Schotten et al (2016) have found that ferritin levels on average require at least 180 days to return to pre-donation levels in a sample of 50 male whole blood donors aged 30-50 years [5].…”

Section: Introductionmentioning

confidence: 99%

Ferritin Trajectories over Repeated Whole Blood Donations: Results from the FIND+ Study

Moazzen

Sweegers

Janssen

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Depending on post-donation erythropoiesis, available iron stores, and iron absorption rates, optimal donation intervals may differ between donors. This project aims to define subpopulations of donors with different ferritin trajectories over repeated donations. Methods: Ferritin levels of 300 new whole blood donors were measured from stored (lookback) samples from each donation over two years in an observational cohort study. Latent classes of ferritin level trajectories were investigated separately using growth mixture models for male and female donors. General linear mixed models assessed associations of ferritin levels with subsequent iron deficiency and/or low hemoglobin. Results: Two groups of donors were identified using group-based trajectory modeling in both genders. Ferritin levels showed rather linear reductions among 42.9% of male donors and 87.7% of female donors. For the remaining groups of donors, steeper declines in ferritin levels were observed. Ferritin levels at baseline and the end of follow-up varied greatly between groups. Conclusion: Repeated ferritin measurements show depleting iron stores in all-new whole blood donors, the level at which mainly depends on baseline ferritin levels. Tailored, less intensive donation strategies might help to prevent low iron in donors, and could be supported with ferritin monitoring and/or iron supplementation.

show abstract

“…European legislation on selection criteria of blood donors (EU directive 2004/33/EC Article 4) states that haemoglobin concentration should be ≥125 g/L for women and ≥ 135 g/L for men before allowing blood donation 3 . There is, however, substantial variation across national blood services in methods of haemoglobin measurement 4,5 . This has resulted in part because the timing of blood sampling and sample material for assessing blood donors is not defined by legislation, and partly because there is little evidence about the comparative performance of different rapid measurement methods 6‐11 …”

Section: Introductionmentioning

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

Self Cite

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

Variations in hemoglobin measurement and eligibility criteria across blood donation services are associated with differing low‐hemoglobin deferral rates: a BEST Collaborative study

Cited by 19 publications

References 23 publications

Supplemental findings of the 2019 National Blood Collection and Utilization Survey

Supplemental findings of the 2019 National Blood Collection and Utilization Survey

Ferritin Trajectories over Repeated Whole Blood Donations: Results from the FIND+ Study

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

Contact Info

Product

Resources

About