International Journal of Pharma and Bio Sciences
 
 
    ISSN 0975-6299
www.ijpbs.net


ORIGINAL RESEARCH ARTICLE
Int J Pharm Bio Sci Volume 15 Issue 2, April-June, Pages:9-17

Analyzing the Requirement for Screening Platelet Donors for Iron Deficiency: A Critical Appraisal

Anju Radhakrishna Kurup, Sheeja Nandhana, Kongodantavida Dyana, Murugesan Mohandoss and Edakkadath Raghavan Sindhu
DOI: http://dx.doi.org/10.22376/Ijpbs.2024.15.2.b9-17
Abstract:

Platelet apheresis is a critical medical procedure that relies heavily on the health and well-being of donors. While donors can undergo platelet apheresis up to 24 times a year, concerns have arisen regarding the potential impact on their iron stores. This study aims to assess the iron status of first-time apheresis donors and frequent plateletpheresis donors, exploring the use of serum ferritin measurements in optimizing donor management and preventing iron deficiency anemia. A prospective study involving male donors at a tertiary care blood center was conducted over a year. Frequent platelet donors, defined as those donating a minimum of six double-dose platelet apheresis procedures within a year, were included. Blood samples were collected from first-time platelet donors (n=10) and frequent platelet donors (n=21) for serum ferritin and erythropoietin measurements. Frequent platelet donors exhibited lower median ferritin levels and higher serum erythropoietin levels than first-time donors. However, these differences were not statistically significant. Among frequent donors, low ferritin levels were observed in 28.6% of donors, while serum erythropoietin levels were elevated in 9.5%. Donors with shorter inter-donation intervals showed reduced ferritin levels, with 30.8% and 33% of donors donating every 2-4 weeks and 4-8 weeks, respectively, having low ferritin levels. Predonation hemoglobin levels showed a weak positive correlation with serum ferritin and a weak negative correlation with serum erythropoietin. Our study suggests that the need for occasional testing of ferritin and erythropoietin, such as at the first donation and every eighth donation thereafter, may be sufficient to identify and defer anemic donors. However, our results may not generalize to higher donation frequencies, and further research is needed. A significant proportion of repeat platelet donors exhibited diminished ferritin levels, suggesting reduced iron stores. The utility of serum erythropoietin as a predictive tool for iron deficiency screening in platelet donors appears limited. Therefore, we recommend considering annual serum ferritin screening and appropriate iron supplementation to support the well-being of repeat platelet donors and ensure the continued success of platelet apheresis programs.

Keywords: Blood donors, Platelet apheresis, Iron stores, Ferritin, Erythropoietin, Haemoglobin
Full HTML:
  1. Basu D, Kulkarni R. Overview of blood components and their preparation. Indian J Anaesth. 2014;58(5):529-37. doi: 10.4103/0019-5049.144647, PMID 25535413.
  2. Vinkenoog M, van den Hurk K, van Kraaij M, van Leeuwen M, Janssen MP. First results of a ferritin?based blood donor deferral policy in the Netherlands. Transfusion. 2020 Aug;60(8):1785-92. doi: 10.1111/trf.15906, PMID 32533600.
  3. Mantadakis E, Panagopoulou P, Kontekaki E, Bezirgiannidou Z, Martinis G. Iron deficiency and blood donation: links, risks and management. J Blood Med. 2022 Dec 10;13:775-86. doi: 10.2147/JBM.S375945, PMID 36531435.
  4. Skikne B, Lynch S, Borek D, Cook J. Iron, and blood donation. ClinHaematol. 1984 Feb;13(1):271-87. doi: 10.1016/S0308-2261(18)30044-4, PMID 6373083.
  5. Page EA, Harrison JF, Jaldow EJ, Kopelman M. Impairment of short-term memory associated with low iron stores in a volunteer multidoseplateletpheresis donor. Transfus Med. 2008 Oct;18(5):312-4. doi: 10.1111/j.1365-3148.2008.00887.x, PMID 18937740.
  6. Kassebaum NJ, Jasrasaria R, Naghavi M, Wulf SK, Johns N, Lozano R, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014 Jan 30;123(5):615-24. doi: 10.1182/blood-2013-06-508325, PMID 24297872.
  7. Kiss JE, Vassallo RR. How do we manage iron deficiency after blood donation? British Journal of Haematology. 2018; 181(5), 590-603. https://doi.org/10.1111/bjh.15136
  8. Conrad ME, Umbreit JN, Moore EG. Iron absorption and transport. Am J Med Sci. 1999 Oct;318(4):213-29. doi: 10.1097/00000441-199910000-00002, PMID 10522550.
  9. Finch CA, Cook JD, Labbe RF, Culala M. Effect of blood donation on iron stores as evaluated by serum ferritin. Blood. 1977 Sep;50(3):441-7, PMID 884321.
  10. Simon TL, Garry PJ, Hooper EM. Iron stores in blood donors. JAMA. 1981 May 22;245(20):2038-43. doi: 10.1001/jama.1981.03310450030018, PMID 7230400.
  11. Chin LT, Woon JY, Kuo SW, Lu SC. Decreased ferritin levels, mild thrombocytosis, and increased erythropoietin are sequential events among frequent plateletpheresis donors: implication for a ferritin screen. TransfusApher Sci. 2022 Dec 1;61(6):103501. doi: 10.1016/j.transci.2022.103501, PMID 35835689.
  12. Jelkmann W. Erythropoietin: structure, control of production, and function. Physiol Rev. 1992 Apr;72(2):449-89. doi: 10.1152/physrev.1992.72.2.449, PMID 1557429.
  13. Pearson TC. Evaluation of diagnostic criteria in polycythemiavera. SeminHematol. 2001 Jan;38(1);Suppl 2:21-4. doi: 10.1016/s0037-1963(01)90136-2, PMID 11242598.
  14. Jacobs A, Miller F, Worwood M, Beamish MR, Wardrop CA. Ferritin is in the Serum of normal subjects and patients with iron deficiency and iron overload. Br Med J. 1972 Oct 28;4(5834):206-8. doi: 10.1136/bmj.4.5834.206, PMID 5082548.
  15. Walters GO, Miller FM, Worwood M. Serum ferritin concentration and iron stores in normal subjects. J ClinPathol. 1973 Oct;26(10):770-2. doi: 10.1136/jcp.26.10.770, PMID 4750458.
  16. Lee HT, Park PW, Seo YH, Kim KH, Seo JY, Jeong JH, et al. Performance evaluation of Mindray CAL 8000(BC-6800 and SC-120) hematologyanalyzer and slidemaker/stainer. J Clin Lab Anal. 2017;31(4):e22065. doi: 10.1002/jcla.22065, PMID 27660110.
  17. Thokala RP, Radhakrishnan K, Anandan A, Panicker VK. Recovery of platelet count among apheresis platelet donors. J ClinDiagn Res. 2016 Dec;10(12):EC01-4. doi: 10.7860/JCDR/2016/21070.8997, PMID 28208861.
  18. Hasan MI, Noordin SS, Hami R, Ishak N, Achuthan A. The effectiveness of iron education through a mobile application on donor return after deferral for low hemoglobin. Blood Transfus. 2022 Nov;20(6):446-53. doi: 10.2450/2022.0018-22, PMID 35848625.
  19. Anju J, Abhishekh B, Debdatta B, Bobby Z, Sharan M. Assessment of iron status in regular blood donors in a tertiary care hospital in Southern India. Asian J Transfus Sci. 2022;16(2):186-93. doi: 10.4103/ajts.ajts_119_21, PMID 36687540.
  20. Knovich MA, Storey JA, Coffman LG, Torti SV, Torti FM. Ferritin for the clinician. Blood Rev. 2009;23(3):95-104. doi: 10.1016/j.blre.2008.08.001, PMID 18835072.
  21. Dignass A, Farrag K, Stein J. Limitations of serum ferritin in diagnosing iron deficiency in inflammatory conditions. Int J Chronic Dis. 2018;2018:9394060. doi: 10.1155/2018/9394060, PMID 29744352.
  22. Bermejo F, García-López S. A guide to diagnosis of iron deficiency and iron deficiency anemia in digestive diseases. World J Gastroenterol. 2009;15(37):4638-43. doi: 10.3748/wjg.15.4638, PMID 19787826.
  23. Abdullah SM. The effect of repeated blood donations on the iron status of male Saudi blood donors. Blood Transfus. 2011;9(2):167-71. doi: 10.2450/2010.0040-10, PMID 21084007.
  24. Norashikin J, Roshan TM, Rosline H, Zaidah AW, Suhair AA, Rapiaah M. A study of serum ferritin levels among male blood donors in Hospital UniversitiSains Malaysia. Southeast Asian J Trop Med Public Health. 2006 Mar;37(2):370-3. PMID 17125001.
  25. Zivot A, Lipton JM, Narla A, Blanc L. Erythropoiesis: insights into pathophysiology and treatments in 2017. Mol Med. 2018 Mar 23;24(1):11. doi: 10.1186/s10020-018-0011-z, PMID 30134792.
  26. Koury MJ. Abnormal erythropoiesis and the pathophysiology of chronic anemia. Blood Reviews. 2014;28(2), 49-66. https://doi.org/10.1016/j.blre.2014.01
  27. Marik PE. Transfusion of blood and blood products. Evid-Based Crit Care. 2014:585-619. doi: 10.1007/978-3-319-11020-2_38.
  28. Mast AE, Szabo A, Stone M, Cable RG, Spencer BR, Kiss JE, et al. The benefits of iron supplementation following blood donation vary with baseline iron status. Am J Hematol. 2020;95(7):784-91. doi: 10.1002/ajh.25800, PMID 32243609.
  29. Jelkmann W. Physiology and pharmacology of erythropoietin. Transfus Med Hemother. 2013;40(5):302-9. doi: 10.1159/000356193, PMID 24273483.
  30. Schotten N, Laarakkers CM, Roelofs RW, Origa R, van Kraaij MG, Swinkels DW. EPO and hepcidin plasma concentrations in blood donors and β-thalassemia intermedia are not related to commercially tested plasma ERFE concentrations. Am J Hematol. 2017;92(3):E29-31. doi: 10.1002/ajh.24636, PMID 28033686.
  31. Cable RG, Glynn SA, Kiss JE, Mast AE, Steele WR, Murphy EL, et al. Iron deficiency in blood donors: the REDS-II Donor Iron Status Evaluation (RISE) study. Transfusion. 2012;52(4):702-11. doi: 10.1111/j.1537-2995.2011.03401.x, PMID 22023513.
  32. Di Angelantonio E, Thompson SG, Kaptoge S, Moore C, Walker M, Armitage J et al. Efficiency and safety of varying the frequency of whole blood donation (INTERVAL): a randomized trial of 45?000 donors. Lancet. 2017;390(10110):2360-71. doi: 10.1016/S0140-6736(17)31928-1, PMID 28941948.
[Download PDF]
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy
Pharmaceutical Fields
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmaceutics
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Novel drug delivery system
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Nanotechnology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacognosy
© Copyright 2009-2015 IJPBS, India. All rights reserved. Specialized online journals by ubijournal. Website by Ubitech Solutions
         Home I Contact I Terms & Conditions