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. 2011 Mar;51(3):511-22.
doi: 10.1111/j.1537-2995.2010.02865.x. Epub 2010 Aug 30.

Iron deficiency in blood donors: analysis of enrollment data from the REDS-II Donor Iron Status Evaluation (RISE) study

Ritchard G Cable  1 , Simone A Glynn, Joseph E Kiss, Alan E Mast, Whitney R Steele, Edward L Murphy, David J Wright, Ronald A Sacher, Jerry L Gottschall, Vibha Vij, Toby L Simon; NHLBI Retrovirus Epidemiology Donor Study-II
Collaborators, Affiliations

Iron deficiency in blood donors: analysis of enrollment data from the REDS-II Donor Iron Status Evaluation (RISE) study

Ritchard G Cable et al. Transfusion. 2011 Mar.

Abstract

Background: Regular blood donors are at risk of iron deficiency, but characteristics that predispose to this condition are poorly defined.

Study design and methods: A total of 2425 red blood cell donors, either first-time (FT) or reactivated donors (no donations for 2 years) or frequent donors, were recruited for follow-up. At enrollment, ferritin, soluble transferrin receptor (sTfR), and hemoglobin were determined. Donor variables included demographics, smoking, dietary intake, use of iron supplements, and menstrual and/or pregnancy history. Models to predict two measures of iron deficiency were developed: Absent iron stores (AIS) were indicated by a ferritin level of less than 12 ng/mL and iron-deficient erythropoiesis (IDE) by a log(sTfR/ferritin) value of 2.07 or greater.

Results: A total of 15.0% of donors had AIS and 41.7% IDE. In frequent donors, 16.4 and 48.7% of males had AIS and IDE, respectively, with corresponding proportions of 27.1 and 66.1% for females. Donation intensity was most closely associated with AIS and/or IDE (odds ratios from 5.3 to 52.2 for different donation intensity compared to FT donors). Being female, younger, and/or menstruating also increased the likelihood of having AIS and/or IDE, as did having a lower weight. Marginally significant variables for AIS and/or IDE were being a nonsmoker, previous pregnancy, and not taking iron supplements. Dietary variables were in general unrelated to AIS and/or IDE, as was race and/or ethnicity.

Conclusion: A large proportion of both female and male frequent blood donors have iron depletion. Donation intensity, sex and/or menstrual status, weight, and age are important independent predictors of AIS and/or IDE. Reducing the frequency of blood donation is likely to reduce the prevalence of iron deficiency among blood donors, as might implementing routine iron supplementation.

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Conflict of interest statement

The remaining authors declare that they have no conflicts of interest relevant to the manuscript

Figures

Figure 1
Figure 1
Effect of 12 month Whole Blood/Red Cell donation frequency on venous hemoglobin by males and pre/post menopausal females
Figure 2
Figure 2
Effect of 12 month Whole Blood/Red Cell donation frequency on the geometric mean of plasma ferritin by males and pre/post menopausal females
See this image and copyright information in PMC

Comment in

  • Iron deficiency in whole blood donors.
    Brittenham GM. Brittenham GM. Transfusion. 2011 Mar;51(3):458-61. doi: 10.1111/j.1537-2995.2011.03062.x. Transfusion. 2011. PMID: 21388389 Free PMC article. No abstract available.

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