Vol 2, No 2 (2009)
Research paper
Published online: 2009-05-18
Temporary blood donor deferrals due to low hemoglobin levels in Polish regional blood centers
Journal of Transfusion Medicine 2009;2(2):73-80.
Abstract
Background: Donor deferrals inevitably lead to loss of donated blood and may affect donorreturn
rates and subsequent blood donations. Low hemoglobin (Hb) levels are among the most
frequent reasons for inability to donate blood, and therefore one of the principal problems
concerning blood donation and blood donor care.
The aim of this study was to estimate the scope of blood donor deferrals caused by low
hemoglobin levels.
Material and methods: Retrospective analysis of 2003–2007 data from Regional Blood Centers was performed, using standardized criteria for donor deferrals. Hb acceptance standards for blood donors were set at two different levels (125 g/l for women, 135 g/l for men).
Results: Within study period (2003–2007), the number of persons appearing for donation in Poland ranged from 534 807 to 623 209 per year. The overall number of temporal deferrals was from 82 591 to 139 539 per year, which is about 18% of persons appearing for donation. Low hemoglobin levels were the reason for deferral in approx. 25% of such cases and for many Regional Blood Centers the most frequent one. However, for reasons which remain unclear, in individual Regional Centers, the Hb-based deferral rates varied widely, ranging from 16.7 to 44.4% of all temporary deferrals. In the 2007 analysis, donors were divided into 3 groups; men and 2 age categories for women. Not surprisingly, Hb-based deferral rate was the lowest for men (3.1% of men appearing for donation), nearly two fold higher for women above 50 (5.7 % of women in this age group appearing for donation) and the highest for younger women (11.6% of women in this age group appearing for donation).
Conclusions: According to our analysis, low hemoglobin levels in blood donors result in significant loss of donated-blood, especially in the group of pre-menopausal women. Such losses could somewhat be avoided, if the interval between donations were prolonged and iron supplementation introduced, whenever necessary. Further studies, including monitoring donors for iron deficiency (e.g. evaluation of serum iron and ferritin levels), could help to elucidate the problem.
Material and methods: Retrospective analysis of 2003–2007 data from Regional Blood Centers was performed, using standardized criteria for donor deferrals. Hb acceptance standards for blood donors were set at two different levels (125 g/l for women, 135 g/l for men).
Results: Within study period (2003–2007), the number of persons appearing for donation in Poland ranged from 534 807 to 623 209 per year. The overall number of temporal deferrals was from 82 591 to 139 539 per year, which is about 18% of persons appearing for donation. Low hemoglobin levels were the reason for deferral in approx. 25% of such cases and for many Regional Blood Centers the most frequent one. However, for reasons which remain unclear, in individual Regional Centers, the Hb-based deferral rates varied widely, ranging from 16.7 to 44.4% of all temporary deferrals. In the 2007 analysis, donors were divided into 3 groups; men and 2 age categories for women. Not surprisingly, Hb-based deferral rate was the lowest for men (3.1% of men appearing for donation), nearly two fold higher for women above 50 (5.7 % of women in this age group appearing for donation) and the highest for younger women (11.6% of women in this age group appearing for donation).
Conclusions: According to our analysis, low hemoglobin levels in blood donors result in significant loss of donated-blood, especially in the group of pre-menopausal women. Such losses could somewhat be avoided, if the interval between donations were prolonged and iron supplementation introduced, whenever necessary. Further studies, including monitoring donors for iron deficiency (e.g. evaluation of serum iron and ferritin levels), could help to elucidate the problem.
Keywords: blood donorsdeferralshemoglobin levelsiron status
References
- Halperin D, Baetens J, Newman B. The effect of short-term, temporary deferral on future blood donation. Transfusion. 1998; 38(2): 181–183.
- Custer B, Johnson ES, Sullivan SD, et al. Quantifying losses to the donated blood supply due to donor deferral and miscollection. Transfusion. 2004; 44(10): 1417–1426.
- Greinacher A, Fendrich K, Alpen U, et al. Impact of demographic changes on the blood supply: Mecklenburg-West Pomerania as a model region for Europe. Transfusion. 2007; 47(3): 395–401.
- Sullivan MT, Cotten R, Read EJ, et al. Blood collection and transfusion in the United States in 2001. Transfusion. 2007; 47(3): 385–394.
- Łętowska M. Medyczne zasady pobierania krwi, oddzielania jej składników i wydawania, obowiązujące w jednostkach organizacyjnych publicznej służby krwi. Instytut Hematologii i Transfuzjologii, Warszawa 2009.
- Guide to the preparation, use and quality assurance of blood components, European Directorate for the Quality of Medicines & HealthCare (EDQM), recommendation No. R (95) 15, wyd. 14 2008.
- Alvarez-Ossorio L, Kirchner H, Klüter H, et al. Low ferritin levels indicate the need for iron supplementation: strategy to minimize iron-depletion in regular blood donors. Transfus Med. 2000; 10(2): 107–112.
- Szymczyk-Nużka M, Wołowiec D. Badania gospodarki żelazowej u wielokrotnych dawców krwi. Pol Arch Med Wewn. 2003; 110: 1415–1421.
- Radtke H, Tegtmeier J, Röcker L, et al. Compensating for iron loss in regular blood donors using ferrous gluconate and ascorbic acid. Transfusion. 2005; 45(7): 1236–1237.
- Skikne B, Lynch S, Borek D, et al. Iron and blood donation. Clin Haematol. 1984; 13(1): 271–287.
- Conrad ME, Crosby WH, Jacobs A, et al. The Hippocratian principle of 'primum nil nocere' demands that the metabolic state of a donor should be normalized prior to a subsequent donation of blood or plasma. How much blood, relative to his body weight, can a donor give over a certain period, without a continuous deviation of iron metabolism in the direction of iron deficiency? Vox Sang. 1981; 41(5-6): 336–343.
- Newman B. Iron depletion by whole-blood donation harms menstruating females: the current whole-blood-collection paradigm needs to be changed. Transfusion. 2006; 46(10): 1667–1681.
- Mast AE, Foster TM, Pinder HL, et al. Behavioral, biochemical, and genetic analysis of iron metabolism in high-intensity blood donors. Transfusion. 2008; 48(10): 2197–2204.
- Cook JD, Skikne BS, Lynch SR, et al. Estimates of iron sufficiency in the US population. Blood. 1986; 68(3): 726–731.
- Røsvik AS, Hervig T, Wentzel-Larsen T, et al. Iron status in Norwegian blood donors: comparison of iron status in new blood donors registered in 1993-1997 and in 2005-2006. Vox Sang. 2009; 96(1): 49–55.