Research Progress in Iron Deficiency among Blood Donors

doi:10.3969/j.issn.1671-2587.2023.05.021

JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE ›› 2023, Vol. 25 ›› Issue (5): 699-705.DOI: 10.3969/j.issn.1671-2587.2023.05.021

Previous Articles Next Articles

Research Progress in Iron Deficiency among Blood Donors

LI Bo, ZENG Xianglong

Department of Blood Transfusion,925th Hospital of PLA Joint Logistics Support Force,Guiyang 550009

Received:2023-06-19 Online:2023-10-20 Published:2023-11-20

Abstract

Abstract: Blood donors and the blood components they willingly provide play a key role in the healthcare system service in all over the world. As a result of one donation, particularly whole blood donors will loss part of their total iron stores. The cumulative effect of repeat blood donations without sufficient iron replacement or a longer interval between donations results in iron deficiency (ID) in many donors, even anemia in some. Moreover, ID can be associated with side effects that can impact a blood donor's health, such as fatigue, cognitive changes and other factors, that may prevent the donors from maintaining long-term blood donation. In an effort to better identify and prevent ID, blood collection agencies are recommending various strategies, including changes in the donation interval, donation frequency, testing of iron status and iron supplementation. This review summarizes the progress in related research area.

Key words: Blood donor, Iron deficiency, Ferritin measurement, Interdonation interval, Iron supplement

CLC Number:

R457

LI Bo, ZENG Xianglong. Research Progress in Iron Deficiency among Blood Donors[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(5): 699-705.

References

[1] GBD 2016 Disease and Injury Incidence and Prevalence Collaborators.Global,regional,and national incidence,prevalence,and years lived with disability for 328 diseases and injuries for 195 countries,1990-2016:a systematic analysis for the Global Burden of Disease Study 2016BD 2016 Disease and Injury Incidence and Prevalence Collaborators.Global,regional,and national incidence,prevalence,and years lived with disability for 328 diseases and injuries for 195 countries,1990-2016:a systematic analysis for the Global Burden of Disease Study 2016[J].Lancet,2017,390(10100):1211-1259.
[2] WHO.Global nutrition targets2025: anaemia policy brief (WHO/NMH/NHD/14.4).Geneva: World Health Organization; 2014.[EB/OL].https://www.who.int/publications/i/item/WHO-NMH-NHD-14.4.
[3] CABLE R G,GLYNN S A,KISS J E,et al.Iron deficiency in blood donors:the REDS-II Donor Iron Status Evaluation (RISE) study[J].Transfusion,2012,52(4):702-711.
[4] RIGAS A S,SORENSEN C J,PEDERSEN O B,et al.Predictors of iron levels in 14,737 Danish blood donors:results from the Danish Blood Donor Study[J].Transfusion,2014,54(3 Pt 2):789-796.
[5] KISS J E,VASSALLO R R.How do we manage iron deficiency after blood donation?[J].Br J Haematol,2018,181(5):590-603.
[6] GOLDMAN M,MAGNUSSEN K,GORLIN J,et al.International Forum regarding practices related to donor haemoglobin and iron[J].Vox Sang,2016,111(4):449-455.
[7] 王雪珩,邱艳,郑鸿尘,等.献血人群铁缺乏影响因素及干预措施的研究进展[J].中华流行病学杂志,2022,43(3):440-444.
[8] BIANCO C,BRITTENHAM G,GILCHER R O,et al.Maintaining iron balance in women blood donors of childbearing age:summary of a workshop[J].Transfusion,2002,42(6):798-805.
[9] NEWMAN B.Iron depletion by whole-blood donation harms menstruating females:the current whole-blood-collection paradigm needs to be changed[J].Transfusion,2006,46(10):1667-1681.
[10] KISS J E,BIRCH R J,STEELE W R,et al.Quantification of body iron and iron absorption in the REDS-II Donor Iron Status Evaluation (RISE) study[J].Transfusion,2017,57(7):1656-1664.
[11] HELMER O M,EMERSON C P.The iron content of the whole blood of normal individuals[J].J Biol Chem,1934,104(1):157-161.
[12] DI ANGELANTONIO E,THOMPSON S G,KAPTOGE S,et al.Efficiency and safety of varying the frequency of whole blood donation (INTERVAL):a randomised trial of 45000 donors[J].Lancet,2017,390(10110):2360-2371.
[13] 郭瑾,施欣,王瑞,等.北京地区全血献血者铁蛋白调查分析[J].中国输血杂志,2021,34(1):4-7.
[14] GARRY P,KOEHLER K,SIMON T.Iron stores and iron absorption:effects of repeated blood donations[J].Am J Clin Nutr,1995,62(3):611-620.
[15] GIRELLI D,NEMETH E,SWINKELS D W.Hepcidin in the diagnosis of iron disorders[J].Blood,2016,127(23):
2809-2813.
[16] HUTCHINSON C,GEISSLER C A,POWELL J J,et al.Proton pump inhibitors suppress absorption of dietary non-haem iron in hereditary haemochromatosis[J].Gut,2007,56(9):1291-1295.
[17] BIALKOWSKI W,KISS J E,WRIGHT D J,et al.Estimates of total body iron indicate 19 Mg and 38 Mg oral iron are equivalent for the mitigation of iron deficiency in individuals experiencing repeated phlebotomy[J].Am J Hematol,2017,92(9):851-857.
[18] MORETTI D,GOEDE J S,ZEDER C,et al.Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women[J].Blood,2015,126(17):1981-1989.
[19] MORETTI D,GOEDE J S,ZEDER C,et al.Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women[J].Blood,2015,126(17):1981-1989.
[20] SCHRIER S L.So You know how to treat iron deficiency anemia[J].Blood,2015,126(17):1971.
[21] TOLKIEN Z,STECHER L,MANDER A P,et al.Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults:a systematic review and meta-analysis[J].PLoS One,2015,10(2):e0117383.
[22] INABA S,TAKANASHI M,MATSUZAKI K,et al.Analysis of a questionnaire on adverse reactions to blood donation in Japan[J].Transfus Apher Sci,2013,48(1):21-34.
[23] AABB.AABB donor iron deficiency risk-based decision-making assessment report supplemental material.[EB/OL].https://www.aabb.org/tm/Documents/AABB-Donor-Iron-Deficiency RBDM-Assessment-Report-Supplemental-Material.pdf.
[24] VASSALLO R R.Donor iron depletion:beneficial or burdensome?[J].Transfusion,2019,59(7):2184-2186.
[25] MOORE C,BOLTON T,WALKER M,et al.Recruitment and representativeness of blood donors in the INTERVAL randomised trial assessing varying inter-donation intervals[J].Trials,2016,17(1):458.
[26] HOD E A,BRITTENHAM G M,BITAN Z C,et al.A randomized trial of blood donor iron repletion on red cell quality for transfusion and donor cognition and well-being[J].Blood,2022,140(25):2730-2739.
[27] ALEXANDER H D,SHERLOCK J P,BHARUCHA C.Red cell indices as predictors of iron depletion in blood donors[J].Clin Lab Haematol,2000,22(5):253-258.
[28] CABLE R G,STEELE W R,MELMED R S,et al.The difference between fingerstick and venous hemoglobin and hematocrit varies by sex and iron stores[J].Transfusion,2012,52(5):1031-1040.
[29] BAART A M,VAN NOORD P A H,VERGOUWE Y,et al.High prevalence of subclinical iron deficiency in whole blood donors not deferred for low hemoglobin[J].Transfusion,2013,53(8):1670-1677.
[30] RADTKE H,MEYER T,KALUS U,et al.Rapid identification of iron deficiency in blood donors with red cell indexes provided by Advia 120[J].Transfusion,2005,45(1):5-10.
[31] KISS J E,STEELE W R,WRIGHT D J,et al.Laboratory variables for assessing iron deficiency in REDS-II Iron Status Evaluation (RISE) blood donors[J].Transfusion,2013,53(11):2766-2775.
[32] KISS J E,BRAMBILLA D,GLYNN S A,et al.Oral iron supplementation after blood donation:a randomized clinical trial[J].JAMA,2015,313(6):575-583.
[33] DIJKSTRA A,VAN DEN HURK K,BILO H J G,et al.Repeat whole blood donors with a ferritin level of 30 μg/L or less show functional iron depletion[J].Transfusion,2019,59(1):21-25.
[34] WHO.WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations[M].Geneva: World Health Organization; 2020.
[35] HALLBERG L,BENGTSSON C,LAPIDUS L,et al.Screening for iron deficiency:an analysis based on bone-marrow examinations and serum ferritin determinations in a population sample of women[J].Br J Haematol,1993,85(4):787-798.
[36] MAST A E,BIALKOWSKI W,BRYANT B J,et al.A randomized,blinded,placebo-controlled trial of education and iron supplementation for mitigation of iron deficiency in regular blood donors[J].Transfusion,2016,56(6pt2):1588-1597.
[37] PASRICHA S R,MARKS D C,SALVIN H,et al.Postdonation iron replacement for maintaining iron stores in female whole blood donors in routine donor practice:results of two feasibility studies in Australia[J].Transfusion,2017,57(8):1922-1929.
[38] AABB.Standards for Blood Banks and Transfusion Services, 30th edn[S].2016.
[39] AABB.AABB Association Bulletin #17-02: updated strategies to limit or prevent iron deficiency in blood donors[EB/OL].http://www.aabb.org/programs/publications/bulletins/Docs/ab17-02.pdf.
[40] JPAC.Guidelines for the Blood Transfusion Services in the UK(8th Edition)[EB/OL].https://www.transfusionguidelines.org/red-book.
[41] SWEEGERS M,ZALPURI S,QUEE F,et al.Ferritin measurement IN Donors—effectiveness of iron Monitoring to diminish iron deficiency and low haemoglobin in whole blood donors (FIND'EM):study protocol for a stepped wedge cluster randomised trial[J].Trials, 2020,21(1):823.
[42] GOLDMAN M,UZICANIN S,OSMOND L,et al.Two-year follow-up of donors in a large national study of ferritin testing[J].Transfusion,2018,58(12):2868-2873.
[43] GOLDMAN M,UZICANIN S,OSMOND L,et al.A large national study of ferritin testing in Canadian blood donors[J].Transfusion,2017,57(3):564-570.
[44] CABLE R G,BRAMBILLA D,GLYNN S A,et al.Effect of iron supplementation on iron stores and total body iron after whole blood donation[J].Transfusion,2016,56(8):2005-2012.
[45] SCHOTTEN N,PASKER-DE JONG P C M,MORETTI D,et al.The donation interval of 56 days requires extension to 180 days for whole blood donors to recover from changes in iron metabolism[J].Blood,2016,128(17):2185-2188.
[46] CABLE R G,BIRCH R J,SPENCER B R,et al.The operational implications of donor behaviors following enrollment in STRIDE (Strategies to Reduce Iron Deficiency in blood donors)[J].Transfusion,2017,57(10):2440-2448.
[47] 马维娟,王同显,马保凤.献血相关性铁缺乏及其应对策略[J].中国输血杂志,2017,30(11):1307-1311.
[48] PASRICHA S R,TYE-DIN J,MUCKENTHALER M U,et al.Iron deficiency[J].Lancet,2021,397(10270):233-248.
[49] TRUMBO P,YATES A A,SCHLICKER S,et al.Dietary reference intakes:vitamin A,vitamin K,arsenic,boron,chromium,copper,iodine,iron,manganese,molybdenum,nickel,silicon,vanadium,and zinc[J].J Am Diet Assoc,2001,101(3):294-301.
[50] SPENCER B R,JOHNSON B,WRIGHT D J,et al.Potenti al impact on blood availability and donor iron status of changes to donor hemoglobin cutoff and interdonation intervals[J].Transfusion,2016,56(8):1994-2004.
[51] GOLDMAN M,STEELE W R,DI ANGELANTONIO E,et al.Comparison of donor and general population demographics over time:a BEST Collaborative group study[J].Transfusion,2017,57(10):2469-2476.
[52] JAHANSHAD N,KOHANNIM O,HIBAR D P,et al.Brain structure in healthy adults is related to serum transferrin and the H63D polymorphism in the HFE gene[J].Proc Natl Acad Sci U S A,2012,109(14): E851-E859.
[53] GOGTAY N,GIEDD J N,LUSK L,et al.Dynamic mapping of human cortical development during childhood through early adulthood[J].Proc Natl Acad Sci USA,2004,101(21):8174-8179.
[54] 李玲,王金花,邵雷,等.2018年江苏地区全血献血者铁营养状况调查[J].中国输血杂志,2020,33(9):950-952.
[55] 李晓瑜,李艳平,王竹天,等.食品中不同铁强化措施的安全性研究[J].中国食品卫生杂志,2010,22(4):293-299.

Research Progress in Iron Deficiency among Blood Donors

RichHTML

PDF

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

About

Author

Journal

Access Statistics

Contact

[1]	ZHONG Xin, QIU Haochuan, CHEN Siliang, et al. Analysis of the Diagnostic Value of Low Hemoglobin Density in Iron Deficiency Anemia and Iron Deficiency in Hemodialysis Anemia Patients [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(5): 654-661.
[2]	HU Tingting, ZOU Binbin, ZHAO Feixue. Assessment of Residual Risk of HIV Transmission among Voluntary Blood Donors in Changsha Area [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(4): 509-513.
[3]	YANG Jian-hao, XU Bei, QIU Ying-jie, et al. Study on Disinfection Effect of Povidone-iodine Disinfection Method of Arm Skin on Different Donors [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2022, 24(4): 459-463.
[4]	WANG Cui-e, KONG Chang-hong, XU Ye-biao, et al. Establishment and Application of Interval Information Sharing System between Blood Donors and Plasma Donors in Zhejiang Province [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(6): 719-722.
[5]	REN Ya-na, ZHOU Guo-ping. A Reentry Program for NAT Reactive Blood Donors [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(5): 639-643.
[6]	ZHANG Zhen, HONG Jun, XU Yu-qian, et al. Serological and Molecular Genetic Characteristics of ABO Subgroups among Blood Donors in Wuxi [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(5): 644-647.
[7]	LIAO Hong-mei, MAO Wei, XIANG Yu-pei, et al. Study on the Changes of Blood Biochemical Indicators in Frequent Plateletpheresis Donors with an Interval of 14~16 Days [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(5): 652-654.
[8]	WANG Ke-cheng, WANG Xiao-qin, YAN Feng, et al. Application of Standard Script in the Communication of Blood Donors [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(5): 655-658.
[9]	QUAN Jun-hui, ZHANG Ming-gang, SHAO Xiang, et al. Rh Phenotype Distribution and Red Blood Cells Antigen Matching for Transfusion in Blood Donors and Recipients in Xi'an [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(3): 310-314.
[10]	CHEN Lan-lan, ZHANG Yan-hua, CHE Jin, et al. Analysis on Blood Routine Indicators and Others in Frequent Platelet Apheresis Donors [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(3): 332-336.
[11]	CHEN Bang-rui, ZHAO Lei, XU Ting-ting, et al. Analysis on the Characteristics of TPPA Confirmed Reactive Population of Voluntary Blood Donors in Wuhan [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(3): 336-339.
[12]	ZHAO Na-na, WANG Chao, JIN Hui-xin, et al. Investigation of CD36 Antigen Deficiency in Unpaid Blood Donors in Hefei [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(2): 152-155.
[13]	GUO Wei-jie, LIU Ze-ya, ZHANG Fan, et al. Meta-analysis：Unexpected Antibody Positive Rate of Blood Donors in China [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(2): 202-212.
[14]	LIN Shou, JIANG Wei-mei, ZHAN You-zhi, et al. Epidemiological Characteristics of Recent HIV-1 Infection in Blood Donors in Fuzhou Area [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(2): 212-215.
[15]	CHENG Wei-fang, ZHOU Xue-yong, CUI Wei-ya, et al. Analysis of Two Follow-up Results of Single HBV Nucleic Acid Testing Positive Blood Donors [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2020, 22(5): 514-517.