Corporate Medical Affairs, Vitalant, Scottsdale, Arizona;
Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California; and.
Pediatrics. 2020 Jul;146(1). doi: 10.1542/peds.2019-3316. Epub 2020 Jun 5.
Teenagers aged 16 to 18 are at increased risk for iron deficiency, exacerbated by losses with whole blood (WB) or double red blood cell (2RBC) donations. Required 56-day (WB) or 112-day (2RBC) interdonation intervals (IDIs) are too short for many to replace lost iron without supplements.
Teenagers donating WB or 2RBCs at Vitalant, a national blood provider, had serum ferritin measured at their first and immediately subsequent successful donation from December 2016 to 2018. We modeled postindex log-ferritin as a function of IDI to estimate the shortest intervals that corresponded with 50% to 95% prevalence of adequate donor iron stores (ferritin ≥20 ng/mL female donors, ≥30 ng/mL male donors) at the subsequent donation.
Among 30 806 teenagers, 11.4% of female and 9.7% of male donors had inadequate iron stores at index donation. Overall, 92.6% had follow-up ferritin values within 13 months. Approximately 12 months after WB index donations, >60% of female and >80% of male donors had adequate iron stores (>50% and >70% after 2RBC donations). Follow-up-donation iron stores were highly dependent on index ferritin. Less than half of WB donors with low ferritin at index achieved adequate stores within 12 months. Achieving a ≥90% prevalence of adequate ferritin at 12 months required index values >50 ng/mL.
These findings suggest that postdonation low-dose iron supplements should be strongly encouraged in teenagers with borderline or low iron stores to permit donation without increased risk for symptoms of mild iron depletion. Increasing the minimum recommended IDI to allow time for replacing donation-related iron losses may be desirable for teenagers.
16 至 18 岁的青少年因全血（WB）或双份红细胞（2RBC）捐献而导致铁缺乏的风险增加，这种情况因捐血而加重。对于许多青少年来说，56 天（WB）或 112 天（2RBC）的捐献间隔（IDIs）太短，无法在不补充铁的情况下补充所流失的铁。
2016 年 12 月至 2018 年期间，全国血液供应商 Vitalant 对首次捐献并随后成功捐献的青少年进行了血清铁蛋白检测。我们将捐血后铁蛋白的对数值建模为 IDI 的函数，以估计在随后的捐血中，铁储存量充足（女性捐赠者铁蛋白≥20ng/ml，男性捐赠者铁蛋白≥30ng/ml）的青少年达到 50%至 95%的最短 IDI。
在 30806 名青少年中，11.4%的女性和 9.7%的男性捐赠者在首次捐血时铁储量不足。总体而言，92.6%的人在 13 个月内有后续铁蛋白值。WB 首次捐血后约 12 个月，超过 60%的女性和超过 80%的男性捐赠者铁储量充足（2RBC 捐血后超过 70%）。后续捐血的铁储量高度依赖于首次捐血的铁蛋白。不到一半的首次捐血时铁蛋白低的 WB 捐赠者在 12 个月内达到了充足的铁储量。要在 12 个月内达到 90%以上的铁蛋白充足率，需要首次铁蛋白值＞50ng/ml。
这些发现表明，应强烈鼓励边缘或低铁储存量的青少年在捐血后服用低剂量铁补充剂，以允许捐血而不会增加出现轻度缺铁症状的风险。对于青少年来说，延长最低推荐 IDI 以允许补充捐血相关的铁流失可能是可取的。
