Background: For safety reasons, volunteer whole blood donation requires a minimal hemoglobin (Hb) concentration of > 125 g/l. Since the first generation of apheresis devices caused significant RBC loss, the same Hb eligibility criterion was applied for apheresis donors (APH-D). However, this may exclude many suitable platelet donors (PLT-D) due to low hemoglobin concentration.
Study design and methods: Covering a three year period (1999-2001), the APH-Ds having Hb < or = 125 g/l and donating platelet concentrates (PLC) were retrospectively analyzed focusing on donor safety and donation efficacy. The apheresis procedures were performed using AMICUS and CobeSpectra devices, targeting a PLT yield of 3 x 10(11) PLT per donation. Predonation PLT- and Hb-concentrations were investigated by regression analysis. In addition, hematological changes due to repetitive apheresis donation (APH) were assessed.
Results: From 1999 to 2001, 1864 volunteer PLT-Ds donated 13,716 PLCs. Three hundred and two PLT-Ds (16%) donating 2013 PCs (14.7%) had predonation Hb < or = 125 g/l at the initial donation and constituted the study population. Ninety-five percent were women. Despite repetitive APHs of up to 20 procedures per PLT-D and with donation intervals of <60 days, the individual Hb concentration did not change significantly throughout the observation period. There was no statistically significant reverse correlation between predonation PLT concentration and the degree of anemia.
Conclusions: The eligibility criterion of Hb > or = 125 g/l for APH-D is not justified and leads to exclusion of mainly female volunteer apheresis donors. Repetitive PLT-APH does not negatively affect Hb concentration. Selective recruitment of borderline anemic donors into a PLT-APH program can be done safely and offers an alternative donation opportunity to otherwise excluded volunteer blood donors.