Long-Term Course of Haemoglobin and Ferritin Values in High-Frequency Donors of Whole Blood and Double Erythrocyte Apheresis

Vildana Pehlic; Thomas Volken; Andreas Holbro; Zuzana Jirout; Beatrice Drexler; Andreas Buser; Laura Infanti

doi:10.1159/000509026

Long-Term Course of Haemoglobin and Ferritin Values in High-Frequency Donors of Whole Blood and Double Erythrocyte Apheresis

Transfus Med Hemother. 2021 Mar;48(2):71-78. doi: 10.1159/000509026. Epub 2020 Aug 5.

Authors

Vildana Pehlic¹, Thomas Volken², Andreas Holbro^{1

3}, Zuzana Jirout¹, Beatrice Drexler^{1

3}, Andreas Buser^{1

3}, Laura Infanti^{1

3}

Affiliations

¹ Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland.
² School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.
³ Division of Haematology, University Hospital Basel, Basel, Switzerland.

Abstract

Background: High-intensity donation is a risk factor for iron deficiency in blood donors. Interdonation intervals for whole blood (WB) donation and double unit red blood cell apheresis (2RBC) vary among countries. We retrospectively evaluated the course of haemoglobin (Hb) and ferritin values in men regularly donating WB 4 times a year or 2RBC twice a year (i.e., maximal frequency) over a period of 48 months.

Methods: Data of male donors with 16 WB or 8 2RBC consecutive donations were analysed. The minimum Hb levels for WB donation and 2RBC apheresis (collection of 360 mL RBC) were 135 and 140 g/L, respectively. There was no lower limit set for ferritin, and no iron was substituted.

Results: We identified 294 WB (mean age 53 years, SD 11) and 151 2RBC donors (mean age 48 years, SD 9) who donated at a mean interval of 97 (SD 18) and 201 days (SD 32), respectively, between January 1, 2008, and December 31, 2013. At baseline, Hb and ferritin values were lower in WB donors compared to 2RBC donors, with a mean Hb of 153 g/L (SD 13) versus 159 g/L (SD 8) and a mean ferritin of 44 μg/L (SD 52) versus 73 μg/L (SD 56; p < 0.001 for both parameters), respectively. Ferritin was below 15 μg/L in 40 WB (14%) and in 4 (3%) 2RBC donors. In WB donors, the mean Hb levels at baseline versus last donation showed no significant difference (153 vs. 152 g/L, p = 0.068), whereas the mean ferritin levels decreased significantly (44 vs. 35 μg/L, p < 0.001). The 2RBC donor group displayed a statistically different decrease in both the mean Hb levels (158 vs. 157 g/L; p < 0.05) and the mean ferritin levels (73 vs. 66 μg/L; p = 0.052). The lowest Hb was measured at the 11th WB donation (152 g/L; p < 0.05) and at the 4th 2RBC apheresis (157 g/L; p < 0.05). There was no deferral due to low Hb at any time. The lowest ferritin was shown at the 4th WB (37 μg/L) and at the 3rd 2RBC donation (60 μg/L), respectively. At the last visit, ferritin was below 15 μg/L in 23 WB donors (8%) and in 2 2RBC donors (1%).

Conclusions: High-intensity male donors with an interdonation interval of 12 weeks for WB donation and 24 weeks for 2RBC apheresis maintain acceptable Hb levels and, after an initial decline, stable ferritin levels despite ongoing blood donation.

Keywords: Ferritin; Haemoglobin; High-frequency donors; Interdonation interval.