Abstract
Risk factors for deferral from red blood cell (RBC) donation due to low hemoglobin are not well defined. We analyzed in a large cohort of returning donors the prognostic value of RBC parameters and serum ferritin regarding low hemoglobin levels at the subsequent visit. Between 2004 and 2009, RBC indices and serum ferritin were recorded in 45,533 visits by 7,994 donors. In 689 instances, donation was deferred at the subsequent visit due to low hemoglobin levels (<123 g/l for female donors, <133 g/l for male donors). Pre-donation hemoglobin at the current visit correlated best with hemoglobin at the subsequent visit (R 2 = 0.63), whereas other RBC indices and serum ferritin correlated only poorly (R 2 ≤ 0.15). Similar results were obtained in ROC curve analysis and in multivariable binary logistic regression. A pre-donation hemoglobin within 5 g/l from the deferral threshold (<128 g/l for female, <138 g/l for male donors) predicted below-threshold hemoglobin levels at the subsequent visit with a sensitivity of 52% and a specificity of 94%. In conclusion, pre-donation hemoglobin is a useful marker identifying donors at risk of developing low hemoglobin levels. Diagnostic and therapeutic interventions should be aimed at donors presenting with hemoglobin levels near the threshold of donor deferral.
Similar content being viewed by others
References
Cable RG, Glynn SA, Kiss JE, Mast AE, Steele WR, Murphy EL, Wright DJ, Sacher RA, Gottschall JL, Vij V, Simon TL (2011) Iron deficiency in blood donors: analysis of enrollment data from the REDS-II Donor Iron Status Evaluation (RISE) study. Transfusion 51(3):511–522
Bryant BJ, Hopkins JA, Arceo SM, Leitman SF (2009) Evaluation of low red blood cell mean corpuscular volume in an apheresis donor population. Transfusion 49(9):1971–1976
Alexander HD, Sherlock JP, Bharucha C (2000) Red cell indices as predictors of iron depletion in blood donors. Clin Lab Haematol 22(5):253–258
Nadarajan V, Sthaneshwar P, Eow GI (2008) Use of red blood cell indices for the identification of iron deficiency among blood donors. Transfus Med 18(3):184–189
Radtke H, Meyer T, Kalus U, Rocker L, Salama A, Kiesewetter H, Latza R (2005) Rapid identification of iron deficiency in blood donors with red cell indexes provided by Advia 120. Transfusion 45(1):5–10
Piedras J, Alvarez E, Herrera FM, Cordova MS (1993) Clinical usefulness of mean corpuscular volume and red cell distribution width in iron deficient blood donors. Rev Invest Clin 45(5):469–472
Mast AE, Foster TM, Pinder HL, Beczkiewicz CA, Bellissimo DB, Murphy AT, Kovacevic S, Wroblewski VJ, Witcher DR (2008) Behavioral, biochemical, and genetic analysis of iron metabolism in high-intensity blood donors. Transfusion 48(10):2197–2204
O’Meara A, Infanti L, Stebler C, Ruesch M, Sigle JP, Stern M, Buser A (2011) The value of routine ferritin measurement in blood donors. Transfusion
Bolan CD, Conry-Cantilena C, Mason G, Rouault TA, Leitman SF (2001) MCV as a guide to phlebotomy therapy for hemochromatosis. Transfusion 41(6):819–827
Boulton F, Collis D, Inskip H, Paes H, Garlick M (2000) A study of the iron and HFE status of blood donors, including a group who failed the initial screen for anaemia. Br J Haematol 108(2):434–439
Gillon J, Wye A, Walker B, Phillips P (2000) Natural history of haemoglobin levels in female blood donors with haemoglobin levels of 120–124 g/l at presentation. Vox Sang 78(4):225–230
Baart AM, de Kort WL, Moons KG, Vergouwe Y (2011) Prediction of low haemoglobin levels in whole blood donors. Vox Sang 100(2):204–211
Ziemann M, Steppat D, Brockmann C, Washington G, Kirchner H, Schlenke P (2006) Selection of whole-blood donors for hemoglobin testing by use of historical hemoglobin values. Transfusion 46(12):2176–2183
Lotfi R, Wernet D, Starke U, Northoff H, Cassens U (2005) A noninvasive strategy for screening prospective blood donors for anemia. Transfusion 45(10):1585–1592
Acknowledgements
M.S. was supported by the Swiss National Science Foundation (grant PP00P3_128461/1). The authors have no competing interests.
Author contributions
AOM, JPS, LI performed research. MS and AOM analyzed data. All authors contributed to writing of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Stern, M., O’Meara, A., Infanti, L. et al. Prognostic value of red blood cell parameters and ferritin in predicting deferral due to low hemoglobin in whole blood donors. Ann Hematol 91, 775–780 (2012). https://doi.org/10.1007/s00277-011-1371-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00277-011-1371-4