Blood donation and iron stores – comparison of double erythrocytapheresis and whole blood donation

Czech version

Authors: R. Procházková
Authors‘ workplace: Transfuzní oddělení, Krajská nemocnice Liberec, a. s.
Published in: Transfuze Hematol. dnes,16, 2010, No. 4, p. 224-229.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Background:
Repeated double erythrocytapheresis and whole blood donation could be accompanied by loss of iron and anemisation. The aim was to evaluate long-term effects of blood donation on iron stores and to find useful parameter for monitoring of them. Methods: Using separator Haemonetics MCS+, we completed double erythrocytaphereses in 30 donors who meet European donor criteria. Hb, Ht and levels of serum iron, transferin, ferritin, sTfR and qTfRi were analyzed on day 0, 30, 90, 180 after the 1th and 2nd apheresis and on day 90, 180 after the 3th collection. In donors without Hb value restoration, we measured occult bleeding. The results were compared with the same parameters in whole blood donors with history of 4 donations per year. P-value < 0,05 was considered statisticaly significant.

Results:
In 30 men, 98 double erythrocytaphereses were performed. Initial values in donors: Hb 152 ± 7 g/l, Ht 0.43 ± 0.02, ferritin 47.3 ± 20.4 μg/l, sTfR 2.92 ± 0.73 mg/l, qTFRi 0.78 ± 0.20. Significant decrease in Hb (147 ± 7 g/l), Ht (0.41 ± 0.02), ferritin (22.1 ± 10.5 μg/l) and increase of values sTfR (4.88 ± 1.03 mg/l) and qTfRi (1.73 ± 0.57) (p < 0.001) were observed on day 30. Hb, Ht and serum iron recovery on day 90 was found in 25 donors. Ferritin recovery on day 180 was observed in 22 donors with baseline ferritin level 50.8 ± 21.3 μg/l, med 41.3. Donors with iron stores depletion on day 180 had baseline ferritin level 34.2 ± 8.3 μg/l (p = 0.004). Partial recovery of transferin, sTfR a qTfRi (p < 0.001) on day 180 was found. In whole blood donors, similar results were found – decrease of iron stores and iron deficiency in several donors. Oral iron supplementation was necessary in three donors in each group. In one erythrocytapheresis donor and in two whole blood donors occult bleeding was noted.

Conclusions:
Repeated double erythrocytaphereses had comparable influence on donor iron status as frequent whole blood donation. The decrease of iron stores in several double erythrocytapheresis donors was found. Thus, we recommend ferritin plasma level > 40 μg/l as preselection criterium for repeated double erythrocytapheresis donors and as a useful parameter for monitoring of iron stores. Oral iron supplementation should be judged on individual bases, the cause of iron deficiency should looked for.

Key words:
double erythrocytapheresis, iron stores, ferritin

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Article was published in

Transfusion and Haematology Today

2010 Issue 4