Medical Officer Canadian Blood Services TORONTO, Ontario, Canada
Background/Case Studies: A majority of regular whole blood donors are iron deficient with higher prevalence amongst female donors and those who donate frequently. Iron deficiency mitigation strategies have included a longer inter-donation interval for female donors (84 days vs. 56 days) and a higher hemoglobin threshold for male donors (130g/L vs. 125g/L). Here we present the data from first year of ferritin testing in select female whole blood donors.
Study
Design/Methods: Data between January 16 2023 and December 31, 2023 female donors at every 10th whole blood donation was collected. Donor demographics, donation frequency and impact on ferritin levels was collected and analyzed. Ferritin ranges were defined as low (≤24mcg/L), adequate (25-299 mcg/L) and high (≥300 mcg/L). Those with low ferritin were asked to pause donation for 6 months and consider iron supplementation.
Results/Findings: In the first year, 736,485 donors donated whole blood. Of these, 313434 were registered as female with a median age of 48 years and hemoglobin 137[131-144]g/L. 36278 were first-time donors, while 277156 were repeat donors. Of the 21753 (6.9%) who had their ferritin tested, 2686 were first-time donors and 19067 were repeat donors. The ferritin amongst first-time donors was higher at 75[IQR44-134]mcg/L compared to repeat donors at 40 [IQR 25-65]mcg/L. 8% of first-time donors had low and 5.5% had high ferritin, while 23.3% of repeats donors had low and 0.8% had a high ferritin. The median hemoglobin value for donors with low ferritin was 134[IQR 129-145] g/L and those with high ferritin was 143[IQR136-151] g/L. Ferritin levels were lower for younger donors. Ferritin levels negatively correlated with donation frequency in the repeat donors cohort. Only 8.8% of donors who made 0 – 1 donations (N=3405) had low ferritin, compared to 71.3% of those (N=11,466) who donated 4 or more times in the previous 2 years. Amongst donors who had their ferritin tested, overall 12 136 (60%) returned for a subsequent whole blood donation. The return rate was lower for those who had low ferritin (2096,39.1%), although 70% of these donors did return within 6 months. Conclusions: Overall, 23.3% of repeat female donors have low ferritin without anaemia. Ferritin is lower amongst those with younger age and higher frequency of blood donation. Further data is required to determine impact of testing on ferritin levels for returning donors and the efficacy of personalized messaging provided to mitigate iron deficiency.
