Pfeiffer Hella, Hechler Johannes, Zimmermann Robert, Hackstein Holger, Achenbach Susanne
Clin Lab. 2021 Feb 1;67(2). doi: 10.7754/Clin.Lab.2020.200506.
Repeat apheresis donation causes a noticeable loss of whole blood: through routine blood tests with every donation as well as through residual blood left within the used apheresis set. While the effect of blood loss on donor iron stores has been widely researched for whole blood donations, fewer and especially contradictory results exist for apheresis donors.
A retrospective analysis of the donor blood samples (Department of Transfusion Medicine, University Hospital Erlangen) of the past 11 years (n = 52.976) was performed. Serum ferritin and hemoglobin were used to detect iron deficiency. Values at admission were compared to values measured at the donations. To investigate the impact of the donation frequency, this frequency was calculated for every single donor (for the whole duration of 11 years as well as for each individual year). Correlation and regression analyses between frequency and iron parameters were performed. A special group were long-time repeat donors, whose changes in ferritin values were analyzed in comparison to the first-ever ferritin value before the first donation.
All donor groups show significantly lower mean ferritin and hemoglobin values after repeated donations than at admission. Interestingly, there are much more iron-depleted females in the control group than there are iron-depleted males. The correlation and regression analysis showed a significant relationship between donation frequency and iron-deficiency in males, but not in females. The analysis of the long-time repeat donors showed that the relative ferritin value dropped more in males than in females. When comparing iron-depleted long-time donors, females tend to be iron-depleted much more often even before the first donation.
Repeat apheresis donation has a noticeable effect on the iron store of the blood donor, leading to a high percentage of iron-deficient donors, especially in women. The very small correlation between donation frequency and iron depletion for females is most likely due to the fact that women tend to be iron-deficient even before the first donation. Because of the natural variation of inter-donation-intervals, the calculated donation frequency might not be that exact. As a result, the correlation between donation frequency and iron stores might be higher than suggested by this work.
重复单采献血会导致全血明显流失，这既体现在每次献血时的常规血液检测中，也体现在使用过的单采设备内残留的血液中。虽然对于全血捐献，失血对献血者铁储备的影响已得到广泛研究，但关于单采献血者的研究较少，且结果尤其相互矛盾。
对过去11年（n = 52976）埃尔朗根大学医院输血医学科的献血者血液样本进行回顾性分析。采用血清铁蛋白和血红蛋白检测铁缺乏情况。将入院时的值与献血时测量的值进行比较。为研究献血频率的影响，计算了每位献血者的献血频率（整个11年期间以及每年）。对频率与铁参数进行相关性和回归分析。一个特殊群体是长期重复献血者，将他们的铁蛋白值变化与首次献血前的首个铁蛋白值进行比较分析。
所有献血者组在重复献血后的平均铁蛋白和血红蛋白值均显著低于入院时。有趣的是，对照组中铁缺乏的女性比男性多得多。相关性和回归分析表明，男性的献血频率与铁缺乏之间存在显著关系，而女性则不然。对长期重复献血者的分析表明，男性铁蛋白相对值下降幅度大于女性。比较铁缺乏的长期献血者时发现，女性在首次献血前就更常出现铁缺乏。
重复单采献血对献血者的铁储备有显著影响，导致铁缺乏献血者的比例很高，尤其是女性。女性献血频率与铁缺乏之间的相关性非常小，很可能是因为女性在首次献血前就往往存在铁缺乏。由于两次献血间隔的自然变化，计算出的献血频率可能并不精确。因此，献血频率与铁储备之间的相关性可能比本研究显示的更高。
