First do no harm: iron loss in whole blood donors

Abstract

AbstractFrequent whole blood donations are known to be related to iron deficiency, potentially leading to donor deferral and iron deficiency‐related symptoms. To ensure that blood donation causes no harm to the donor, it is of importance for blood collection centres to gain insight in whole blood donors’ iron status, how that affects donor health and by what means low iron stores in blood donors should be managed. Since haemoglobin levels do not reflect donors’ true iron status, measuring ferritin might be a better way to detect low iron stores. International consensus on an appropriate strategy for iron monitoring is currently lacking. Multiple strategies for iron monitoring of whole blood donors are available, including haemoglobin‐ or ferritin‐guided donation intervals and iron supplementation. Studies from the USA and Denmark showed that on the introduction of ferritin‐guided donation intervals or iron supplementation, deferral percentages for low haemoglobin declined in both male and female donors. However, implementing an iron monitoring strategy may introduce its own challenges in donor management and donor availability. Here, we present the prevalence and determinants of iron deficiency in blood donors and describe subgroups of donors who may be more prone to iron deficiency. Furthermore, we provide an overview of possible strategies for iron monitoring and describe challenges and implications. Possible adverse events associated with iron deficiency in whole blood donors should be further investigated to evaluate the potential harm to the donor. Evidence‐based insight in measures to prevent iron deficiency could help to develop an appropriate iron monitoring strategy.