Monitoring Hemoglobin and Iron Status in Blood Donors to Prevent Iron Deficiency

2015 ◽  
pp. 131-143 ◽  
Author(s):  
A. Zanella ◽  
S. Milani ◽  
C. Silvani ◽  
L. Gridelli ◽  
A. Berzuini ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Donors ◽  
Iron Status

The Effect of Repeated Blood Donations on the Iron Status of Iranian Blood Donors Attending the Iranian Blood Transfusion Organization

2006 ◽  
Vol 76 (3) ◽  
pp. 132-137 ◽  
Author(s):  
Mahmoud Djalali ◽  
Tirang R. Neyestani ◽  
Jamil Bateni ◽  
Fereydoun Siassi
Keyword(s):  
Iron Deficiency ◽  
Blood Transfusion ◽  
Serum Ferritin ◽  
Blood Donors ◽  
Blood Donation ◽  
Iron Status ◽  
Iron Loss ◽  
Healthy Controls ◽  
Blood Donations ◽  
Group Frequency

Objective: Blood donation leads to substantial iron loss, as about 0.5 mg iron is lost per each milliliter of blood donated. If not compensated for efficiently, the iron loss may eventually lead to anemia, though non-anemic iron deficiency per se may be problematic. The aim of this study was to evaluate the effects of blood donation, and its frequency over a year’s time, on iron status of Iranian male blood donors attended blood transfusion stations of the Iranian Blood Transfusion Organization (IBTO). Design and setting: A cross-sectional, descriptive, and analytic study was conducted. 91 male volunteer blood donors aged from 20 to 50 years attending three IBTO stations located in central areas of Tehran, and 63 apparently healthy controls that were matched for age, gender, monthly income, height, and weight, were included in the study. Blood donors were divided into 4 groups according to the frequency of blood donation per year; i.e. 1, 2, 3, and 4 with 20, 30, 26, and 15 persons in each group, respectively. Just before blood donation, 10 mL venous blood sample was taken and divided into heparinized and non-heparinized tubes for determination of hemoglobin (Hb), hematocrit (Hct), serum iron (SI), total iron binding capacity (TIBC), ferritin, transferrin saturation (TS), and mean corpuscular hemoglobin concentration (MCHC). Dietary assessment was also done using 3 different questionnaires; i.e. general health, food frequency, and 24hr recall. Results: The levels of Hb, Hct, and iron status indices were all significantly lower in the subjects than in controls and a gradual but significant decrease in iron status indices in each time of blood donation was found. Serum ferritin showed significant correlations with age (r = 0.33, p < 0.001) and body-mass index (BMI) (r = 0.26, p = 0.03) only in the control group. Frequency of blood donation per year was also inversely correlated with Hb (r = -0.67, p < 0.001), Hct (r = -0.65, p < 0.001), MCHC (r = -0.56, p < 0.001), serum ferritin (r = -0.38, p < 0.001), SI (r = -0.62, p < 0.001), and TS (r = -0.61, p < 0.001), but was directly correlated with TIBC (r = 0.56, p < 0.001). Interestingly in blood donors, but not in healthy controls, serum ferritin levels showed weak but statistically significant correlations with daily intake of iron (r = 0.17, p < 0.05) and energy (r = 0.20, p = 0.03). Conclusion: Though repeated blood donations might diminish iron status, it could be safe to donate 2–3 U/year without an appreciable incidence of iron deficiency, provided that the pre-donation Hb and ferritin values are ≥ 14.7 g/dL and 58.9 μg/L, respectively. The male volunteers with Hb ≥ 14.2 g/dL and serum ferritin ≥ 57.2 μg/L could donate 1–2 U/year and those with Hb ≥ 13.1 g/dL and serum ferritin ≥ 35.3 μg/L could donate just once a year. Volunteers who undergo (repeated) blood donation should receive special nutritional care, especially in terms of iron and energy.

Validation of the Intrinsic Hepcidin IDxTM Test, an LDT for Clinical Hepcidin Assessment

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2456-2456
Author(s):  
Patrick Gutschow ◽  
Keith Westerman ◽  
Huiling Han ◽  
Vaughn Ostland ◽  
Gordana Olbina ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Donors ◽  
Reference Range ◽  
Iron Status ◽  
Deficiency Anemia ◽  
Employment Equity ◽  
Hepcidin Expression ◽  
Iron Deficient ◽  
Equity Ownership ◽  
First Time

Abstract Introduction: Hepcidin is the principal regulator of iron absorption and iron recycling, and is required to provide iron for erythropoiesis. Hepcidin is a peptide hormone that binds to the sole iron channel ferroportin (Fpn), and blocks iron efflux by degrading Fpn, trapping iron stored in the cell. Dysregulation of hepcidin by genetic mutations affecting hepcidin expression in hepatocytes is responsible for hereditary hemochromatosis where too little hepcidin leads to iron-overload disease, and iron refractory iron deficiency anemia (IRIDA) where hepcidin expression is inappropriately high leading to anemia. Hepcidin itself is regulated by iron and the inflammatory cytokine IL-6. Thus, hepcidin is dysregulated in most inflammatory diseases and chronic infections. Interest in developing diagnostic applications for hepcidin in iron disorders is high. Objective: We developed a high-affinity monoclonal antibody (mAb) to hepcidin and used it to produce a competitive ELISA (C-ELISA) similar to our first RUO test (Ganz et al. 2008). We determined the performance characteristics using CLIA analytical method validation guidelines. The Intrinsic Hepcidin IDx Test is used for serum and Li-Heparin plasma. We determined the reference range in adult first time blood donors (n=292) and studied an iron deficient (ID) sub-set of the donors. Methods: We developed mouse anti-human hepcidin monoclonal antibodies and coated, blocked, and dried the plates in a temperature and humidity controlled incubator. We used highly purified synthetic hepcidin as reference standard and a biotinylated hepcidin analog as the competitive tracer for the C-ELISA (Peptides International, Louisville, KY). The Intrinsic Hepcidin IDx Test is fully automated on the Biomek FX platform. Serum from first time blood donors (n=292) was obtained, and ferritin, transferrin, plasma iron, CRP, and hepcidin were measured. The reference range for hepcidin was determined and the normal iron status range determined by eliminating iron deficient (ID) donors or those shown to be iron overloaded. Receiver operator characteristic curves (ROC) were plotted to determine the utility of hepcidin and to identify optimal cutoffs of hepcidin as a test of iron deficiency. Results: The mAb used in the Intrinsic Hepcidin IDx Test is specific for human hepcidin. The analytical measurement range (AMR) is 4 - 200 ng/ml. The intra-assay precision CVs range between 7% (at 12 ng/ml) and 4% (at 99 ng/ml). The between-day precision CVs range between 7% (12 ng/ml) and 9% (100 ng/ml). The mean spike recovery across the AMR is 3%. Hepcidin was stable at 4oC for up to 7 days and if specimens are stored at -20oC, for at least 6 months. Hepcidin concentrations determined in blood donors were highly correlated with those measured using our polyclonal RUO C-ELISA (r = 0.95, p<0.001). The reference range is 4.4-54.1 ng/ml for women and 6.1-91.2 ng/ml for men. Clear gender differences were observed: hepcidin was higher in men (median 28.5 ng/ml, n = 143) than in women (median 13.1 ng/ml, n = 149). In addition, the ID group had lower hepcidin (median 6.7 ng/ml) than the normal iron status group (median 21.4 ng/ml, p<0.0001). The area under the ROC curve for hepcidin compared with various ferritin concentrations was greater than 0.90. An optimal hepcidin cutoff less than 10 ng/ml was determined to predict ID with a correct classification rate of greater than 86%. Conclusion: We developed and validated a sensitive, accurate and reproducible C-ELISA, the Intrinsic Hepcidin IDx test, using CLIA validation guidelines. We determined the hepcidin reference ranges by analyzing first-time blood donor serum. We found a significant difference in median hepcidin values between genders. Also, our data show that hepcidin was lower in donors with ID compared to iron replete, healthy donors. Disclosures Gutschow: Intrinsic LifeSciences: Employment, Equity Ownership. Westerman:Intrinsic LifeSciences: Employment. Han:Intrinsic Lifesciences.: Employment, Equity Ownership. Ostland:Intrinsic LifeScienc s: Employment, Equity Ownership. Olbina:Intrinsic LifeSciences: Employment, Equity Ownership. Westerman:Intrinsic LifeSciences: Employment, Equity Ownership.

Washing Erythrocytes to Remove Interferents in Measurements of Zinc Protoporphyrin by Front-Face Hematofluorometry

1992 ◽  
Vol 38 (11) ◽  
pp. 2184-2189 ◽  
Author(s):  
J Hastka ◽  
J J Lasserre ◽  
A Schwarzbeck ◽  
M Strauch ◽  
R Hehlmann
Keyword(s):  
Iron Deficiency ◽  
Blood Donors ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Hospitalized Patients ◽  
Front Face ◽  
Zinc Protoporphyrin ◽  
Iron Deficient ◽  
Validation Tests

Abstract Zinc protoporphyrin (ZPP) is determined by hematofluorometry of whole blood to detect iron deficiency in blood donors. In hospitalized patients, ZPP did not correlate with established markers of iron status. We performed 4500 ZPP measurements with the Aviv front-face hematofluorometer in samples from 475 patients and measured ferritin, transferrin saturation, hemoglobin, and erythrocyte indices. We found that the fluorometric determination is affected by substances dissolved in plasma but that this interference can be eliminated by using washed erythrocytes. In validation tests the within-day variation was &lt; 3.5%; the day-to-day variation was &lt; 6.8%. In 130 healthy persons without iron deficiency, ZPP was &lt; or = 40 mumol/mol heme, which we consider a normal value. Mean ZPP in 46 iron-deficient patients was 256 (SD 105) mumol/mol heme (correlation with ferritin: -0.73; with hemoglobin: -0.85; P &lt; 0.001). When washed erythrocytes are used, the hematofluorometric determination of ZPP is sensitive and specific for detecting iron deficiency in otherwise healthy individuals and hospitalized patients.

scholarly journals Iron deficiency in blood donors

2001 ◽  
Vol 119 (4) ◽  
pp. 132-134 ◽  
Author(s):  
Rodolfo Delfini Cançado ◽  
Carlos Sérgio Chiattone ◽  
Fausto Forin Alonso ◽  
Dante Mário Langhi Júnior ◽  
Rita de Cássia Silva Alves
Keyword(s):  
Iron Deficiency ◽  
Blood Donors ◽  
Blood Donation ◽  
Binding Capacity ◽  
Iron Status ◽  
Saturation Index ◽  
Transferrin Saturation ◽  
Laboratory Trial ◽  
Iron Binding Capacity ◽  
First Time

CONTEXT: Blood donation results in a substantial loss of iron (200 to 250 mg) at each bleeding procedure (425 to 475 ml) and subsequent mobilization of iron from body stores. Recent reports have shown that body iron reserves generally are small and iron depletion is more frequent in blood donors than in non-donors. OBJECTIVE: The aim of this study was to evaluate the frequency of iron deficiency in blood donors and to establish the frequency of iron deficiency in blood donors according to sex, whether they were first-time or multi-time donors, and the frequency of donations per year. DESIGN: From September 20 to October 5, 1999, three hundred blood donors from Santa Casa Hemocenter of São Paulo were studied. DIAGNOSTIC TESTS: Using a combination of biochemical measurements of iron status: serum iron, total iron-binding capacity, transferrin saturation index, serum ferritin and the erythrocyte indices. RESULTS: The frequency of iron deficiency in blood donors was 11.0%, of whom 5.5% (13/237) were male and 31.7% (20/63) female donors. The frequency of iron deficiency was higher in multi-time blood donors than in first-time blood donors, for male blood donors (7.6% versus 0.0%, P < 0.05) and female ones (41.5% versus 18.5%, P < 0.05). The frequency of iron deficiency found was higher among the male blood donors with three or more donations per year (P < 0.05) and among the female blood donors with two or more donations per year (P < 0.05). CONCLUSIONS: We conclude that blood donation is a very important factor for iron deficiency in blood donors, particularly in multi-time donors and especially in female donors. The high frequency of blood donors with iron deficiency found in this study suggests a need for a more accurate laboratory trial, as hemoglobin or hematocrit measurement alone is not sufficient for detecting and excluding blood donors with iron deficiency without anemia.

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

Transfusion ◽  
2010 ◽  
Vol 51 (3) ◽  
pp. 511-522 ◽  
Author(s):  
Ritchard G. Cable ◽  
Simone A. Glynn ◽  
Joseph E. Kiss ◽  
Alan E. Mast ◽  
Whitney R. Steele ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Donors ◽  
Iron Status ◽  
Enrollment Data

scholarly journals Laboratory variables for assessing iron deficiency in REDS-II Iron Status Evaluation (RISE) blood donors

Transfusion ◽  
2013 ◽  
Vol 53 (11) ◽  
pp. 2766-2775 ◽  
Author(s):  
Joseph E. Kiss ◽  
Whitney R. Steele ◽  
David J. Wright ◽  
Alan E. Mast ◽  
Patricia M. Carey ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Donors ◽  
Iron Status ◽  
Laboratory Variables

scholarly journals Iron deficiency in blood donors: the REDS-II Donor Iron Status Evaluation (RISE) study

Transfusion ◽  
2011 ◽  
Vol 52 (4) ◽  
pp. 702-711 ◽  
Author(s):  
Ritchard G. Cable ◽  
Simone A. Glynn ◽  
Joseph E. Kiss ◽  
Alan E. Mast ◽  
Whitney R. Steele ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Donors ◽  
Iron Status

scholarly journals Clinical Immunoassay for Human Hepcidin Predicts Iron Deficiency in First-Time Blood Donors

2020 ◽  
Vol 5 (5) ◽  
pp. 943-953
Author(s):  
Patrick Gutschow ◽  
Huiling Han ◽  
Gordana Olbina ◽  
Keith Westerman ◽  
Elizabeta Nemeth ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Homeostasis ◽  
Blood Donors ◽  
Iron Status ◽  
Characteristic Curve ◽  
Serum Markers ◽  
Ferritin Concentration ◽  
Limit Of Quantitation ◽  
Serum Hepcidin ◽  
First Time

Abstract Background Serum markers currently used as indicators of iron status have clinical limitations. Hepcidin, a key regulator of iron homeostasis, is reduced in iron deficiency (ID) and increased in iron overload. We describe the first CLIA-validated immunoassay with excellent accuracy and precision to quantify human serum hepcidin. Its diagnostic utility for detecting ID in first-time blood donors was demonstrated. Methods A monoclonal competitive ELISA (C-ELISA) was developed for the quantitation of human hepcidin and validated according to CLIA guidelines. Sera from nonanemic first-time blood donors (n = 292) were analyzed for hepcidin, ferritin, transferrin, and serum iron. Logistic regression served to determine the utility of hepcidin as a predictor of ID. Results The C-ELISA was specific for human hepcidin and had a low limit of quantitation (4.0 ng/mL). The hepcidin concentration measured with the monoclonal C-ELISA was strongly correlated with a previously established, extensively tested polyclonal C-ELISA (Blood 2008;112:4292–7) (r = 0.95, P &lt; 0.001). The area under the receiver operating characteristic curve for hepcidin as a predictor of ID, defined by 3 ferritin concentration thresholds, was &gt;0.9. For predicting ID defined by ferritin &lt;15 ng/mL, hepcidin &lt;10 ng/mL yielded sensitivity of 93.1% and specificity of 85.5%, whereas the same hepcidin cutoff for ferritin &lt;30 ng/mL yielded sensitivity of 67.6% and specificity of 91.7%. Conclusion The clinical measurement of serum hepcidin concentrations was shown to be a potentially useful tool for diagnosing ID.

Preserving the National Blood Supply

Hematology ◽  
2001 ◽  
Vol 2001 (1) ◽  
pp. 422-432 ◽  
Author(s):  
Gary M. Brittenham ◽  
Harvey G. Klein ◽  
James P. Kushner ◽  
Richard S. Ajioka
Keyword(s):  
Iron Deficiency ◽  
Blood Supply ◽  
Iron Supplementation ◽  
Blood Donors ◽  
Iron Status ◽  
Hereditary Hemochromatosis ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Testing Procedures ◽  
The Us

Abstract This paper examines the current state of the blood supply in the US and focuses on the potential for augmenting blood availability by attention to the iron status of donors. Increasing demands are being made upon the national blood supply as rates of blood donation are declining, in part because of the loss of blood donors as a result of enhanced screening and testing procedures. Iron-related means of expanding the blood supply include the use of blood from individuals undergoing therapeutic phlebotomy for hereditary hemochromatosis and enhancing the retention and commitment of women of childbearing age as donors by using iron supplementation to prevent iron deficiency. In Section I, Dr. Klein discuss the circumstances responsible for a decline in the population of eligible donors, including public attitudes toward donation, factors influencing the retention of donors by blood centers, and the effects of increased screening and testing to maintain the safety of the blood supply. In Section II, Drs. Kushner and Ajioka focus on the consequences of the decision by the US Food and Drug Administration (FDA) to develop recommendations to permit blood centers to collect blood from patients with hereditary hemochromatosis and to distribute this blood obtained without disease labeling if all other screening and testing procedures are passed. After summarizing the pathophysiology of hereditary hemochromatosis, the use by blood centers of blood obtained from heterozygotes and homozygotes for hereditary hemochromatosis is considered. In Section III, Dr. Brittenham reviews the use of low dose, short-term carbonyl iron supplementation for women donors of childbearing age. Replacing the iron lost at donation can help prevent iron deficiency in women of childbearing age and, by decreasing deferral, enhance the retention and commitment of women who give blood regularly. He emphasizes the use by blood centers of iron-related means to enhance recruitment and retention of blood donors.

scholarly journals Hematology and Iron Status Evaluation Based on Donation Characteristics in Dr. Sardjito Hospital, Yogyakarta

2021 ◽  
Vol 27 (3) ◽  
pp. 249
Author(s):  
Fuad Anshori ◽  
Tri Ratnaningsih ◽  
Teguh Triyono
Keyword(s):  
Iron Deficiency ◽  
Blood Donors ◽  
Blood Donation ◽  
Iron Status ◽  
Statistical Significance ◽  
Hematological Parameters ◽  
Short Interval ◽  
The Body ◽  
Iron Storage ◽  
Iron Saturation

Blood donation will reduce iron storage in the body. A high frequency of donations and short interval inter-donations may increase the risk of iron deficiency. In Indonesia, detection of iron deficiency in blood donors is not a routine procedure. Therefore, the comparison of hematology and iron status based on donor characteristics is not widely known. For a month, this study was a cross-sectional study conducted at the Blood Transfusion Service Unit, Dr. Sardjito Hospital. Subjects were routine blood donors who met the criteria for donor selection; however, subjects were excluded if the CRP level was > 10 g/L and had a history of iron supplementation. Subjects were divided based on donation frequency and blood donation interval. The Kruskal-Wallis test was used to compare variables among groups with a statistical significance of p < 0.05. This study involved 145 subjects who met the criteria. Blood donations more than 20 times showed the lowest ferritin levels and iron saturation (16.9 ng/mL and 15.08%). Ferritin levels were also increased in line with the donation interval (35.5 ng/mL; 75.3 ng/mL; 92.7 ng/mL every three months). However, the hematological parameters and iron saturation did not differ significantly based on the donation interval. Hematological parameters are easy and fast procedures but have limitations in the early detection of iron deficiency. Serum ferritin has higher specificity, but its level is affected by inflammatory conditions. Ferritin levels were consistently at the lowest level in the subjects with the highest risk of iron deficiency compared to hematologic and iron saturation parameters.

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