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. 2020 Aug;60(8):1785-1792.
doi: 10.1111/trf.15906. Epub 2020 Jun 13.

First results of a ferritin-based blood donor deferral policy in the Netherlands

Marieke Vinkenoog  1   2 , Katja van den Hurk  1 , Marian van Kraaij  3 , Matthijs van Leeuwen  2 , Mart P Janssen  1
Affiliations

First results of a ferritin-based blood donor deferral policy in the Netherlands

Marieke Vinkenoog et al. Transfusion. 2020 Aug.

Abstract

Background: Whole blood donors are at risk of becoming iron deficient. To monitor iron stores, Sanquin implemented a new deferral policy based on ferritin levels, in addition to the traditional hemoglobin measurements.

Methods: Ferritin levels are determined in every fifth donation, as well as in all first-time donors. Donors with ferritin levels <15 ng/mL (WHO threshold) are deferred for 12 months; those ≥15 and ≤30 ng/mL for 6 months. The first results were analyzed and are presented here.

Results: The results show that 25% of women (N = 20151, 95% CI 24%-25%) and 1.6% of men (N = 10391, 95% CI 1.4%-1.8%) have ferritin levels ≤30 ng/mL at their first blood center visit. For repeat (non-first-time) donors, these proportions are higher: 53% of women (N = 28329, 95% CI 52%-54%) and 42% of men (N = 31089, 95% CI 41%-43%). After a 6-month deferral, in 88% of returning women (N = 3059, 95% CI 87%-89%) and 99% of returning men (N = 3736, 95% CI 98%-99%) ferritin levels were ≥15 ng/mL. After a 12-month deferral, in 74% of returning women (N = 486, 95% CI 70%-78%) and 95% of returning men (N = 479, 95% CI 94%-97%) ferritin levels increased to ≥15 ng/mL.

Conclusion: Deferral of donors whose pre-donation ferritin levels were ≤30 ng/mL might prevent donors from returning with ferritin levels <15 ng/mL. This policy is promising to mitigate effects of repeated donations on iron stores.

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Conflict of interest statement

The authors have disclosed no conflicts of interest.

Figures

Fig .1
Fig .1
Distributions of ferritin levels in new (solid line) and repeat donors (dashed line) for various combinations of sex and age category. Sample sizes range from 1037 (male new donors age 50+) to 14,848 (male repeat donors age 50+).
Fig .2
Fig .2
Probability of deferral due to low ferritin as a function of age in repeat (black) and new (gray) donors. Both deferral for 6 months (ferritin between 15 and 30 ng/mL, dashed line) and deferral for 12 months (ferritin under 15, solid line) are shown. The difference in age ranges is due to the fact that new donors are only accepted until the age of 65, whereas repeat donors can keep donating for several more years.
See this image and copyright information in PMC

References

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