Donation‐induced iron depletion is significantly associated with low hemoglobin at subsequent donations

• Published in: Transfusion (Philadelphia, Pa.) Vol. 61; no. 12; pp. 3344 - 3352
• Main Authors: Prinsze, Femmeke J, Groot, Rosa, Timmer, Tiffany C., Zalpuri, Saurabh, Hurk, Katja
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.12.2021; Wiley Subscription Services, Inc
• Subjects: Blood; Blood & organ donations; blood donation history; Blood Donors; Cross-Sectional Studies; Depletion; Diet; Dietary intake; Female; Ferritin; Ferritins; Hemoglobin; Hemoglobins - analysis; Humans; Iron; Iron Deficiencies; Iron deficiency; low‐Hb deferral; Male; Men; Nutrient deficiency; Post-menopause; Women; low-Hb deferral; blood donation history; ferritin; iron deficiency
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/trf.16688

Background Blood donation is associated with a loss of hemoglobin (Hb)‐bound iron. Hb levels recover relatively fast by using stored iron. However, it takes more time to replenish iron stores, potentially resulting in iron deficiency. Study design Hb and ferritin levels were measured in 5056 new, first‐time, and repeat whole blood donors. We investigated whether increasing numbers of donations are associated with lower ferritin levels. Furthermore, we tested whether low ferritin levels are associated with low‐Hb deferral at the subsequent donation attempt by performing logistic regression adjusted for age and stratified by sex. Results Whereas mean Hb levels are relatively stable, ferritin levels significantly decrease with increasing numbers of donations and were approximately 50% lower for donors with >50 donations compared with those with 2–10 donations. Despite the poor correlation of ferritin and Hb levels, cross‐sectional, iron‐deficient donors (ferritin <15 ng/ml) had 21.8 (8.5–55.6) higher odds in men, 10.1 (6.1–16.5) in premenopausal women, and 11.7 (5.2–26.4) in postmenopausal women for Hb deferral at a subsequent visit. Discussion To conclude, repeated donations may induce iron deficiency, which corresponds with an over tenfold increased risk of having insufficiently restored Hb levels at a subsequent donation attempt. Longer donation intervals and/or higher dietary or supplemental iron intake are warranted to prevent accumulated iron depletion and subsequent low‐Hb deferral in whole blood donors.