(P-BC-18) Comparative Analysis of Invasive versus Noninvasive Hemoglobin Screening Methods: Iron Deficiency in Blood Donors

FDA requires blood donor pre-donation hemoglobin (Hb) screening to ensure donor safety and product potency; Hb ≥12.5 for females, ≥13.0 for males. Acceptable Hb concentration does not assure adequate iron stores, and blood donation may lead to iron deficiency in eligible, but at-risk donors. To mitigate these known risks for development of iron deficiency in young donors, our blood donor center (BDC) measures ferritin in all high school blood collections. Donors with 13 ≤ ferritin ≤ 26 ng/mL (low ferritin, LFR) are deferred from subsequent donation for 4 months, while donors with ferritin ≤ 12 ng/mL (very low ferritin, VLFR) are deferred for 12 months. Approved methods for blood donor Hb screening include noninvasive (NI) methods, which may reduce donor discomfort associated with direct blood sampling. Our hospital based BDC used a fingerstick (FS) sample (CompoLab) for Hb screening through 2022. Starting in 2023, all Hb screening was conducted via the NBM-200 device, a NI Hb screening method. Our study compared the incidence of iron deficiency, as defined by ferritin ≤ 26 ng/mL in the calendar year 2022 (FS Hb screening) vs. 2023 (NI Hb screening).

Study

Design/Methods:

The total number of whole blood donations, (WBD), and donor age, gender, and corresponding ferritin levels were retrospectively reviewed for calendar years 2022 and 2023. Statistical analyses were performed in Excel to compare both years' data as follows: Chi-Square test to assess the difference between the number of WBD with LFR, VLFR, and LFR+VLFR. Student's t-test assessed the difference between the average Hb levels at LFR and VLFR. Significance level was set at p < 0.05 for both tests.


Results/Findings:

A total of 3521 (56.7% Female) WBD were collected by FS in 2022, while 3409 (52.2% Female) were collected in 2023. Descriptive statistics and statistical analyses are summarized in Figure A-(I). More iron deficient donations were identified in eligible WBD screened by the NBM-200 method when compared to eligible WBD screened by the FS method. Among the iron deficient donations, the average Hb level for VLFR WBD, as measured by the NBM-200 method, was higher compared to the FS method. This was not seen in LFR WBD, Figure A-(II).


Conclusions:

Using the NBM-200 device for NI Hb screening may potentially lead to more WB collections from donors with iron deficiency, compared to FS Hb screening. The average measured Hb level is significantly higher in VLFR but not in LFR when measured by NBM-200. The NBM 200 device is an occlusion spectrophotometer based Hb monitor and the mechanism for this possible finding is unclear. Further investigation is needed to determine the best approach to iron deficiency prevention strategies for at risk populations.