Pehlic Vildana, Volken Thomas, Holbro Andreas, Jirout Zuzana, Drexler Beatrice, Buser Andreas, Infanti Laura
Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland.
School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.
Transfus Med Hemother. 2021 Mar;48(2):71-78. doi: 10.1159/000509026. Epub 2020 Aug 5.
High-intensity donation is a risk factor for iron deficiency in blood donors. Interdonation intervals for whole blood (WB) donation and double unit red blood cell apheresis (2RBC) vary among countries. We retrospectively evaluated the course of haemoglobin (Hb) and ferritin values in men regularly donating WB 4 times a year or 2RBC twice a year (i.e., maximal frequency) over a period of 48 months.
Data of male donors with 16 WB or 8 2RBC consecutive donations were analysed. The minimum Hb levels for WB donation and 2RBC apheresis (collection of 360 mL RBC) were 135 and 140 g/L, respectively. There was no lower limit set for ferritin, and no iron was substituted.
We identified 294 WB (mean age 53 years, SD 11) and 151 2RBC donors (mean age 48 years, SD 9) who donated at a mean interval of 97 (SD 18) and 201 days (SD 32), respectively, between January 1, 2008, and December 31, 2013. At baseline, Hb and ferritin values were lower in WB donors compared to 2RBC donors, with a mean Hb of 153 g/L (SD 13) versus 159 g/L (SD 8) and a mean ferritin of 44 μg/L (SD 52) versus 73 μg/L (SD 56; < 0.001 for both parameters), respectively. Ferritin was below 15 μg/L in 40 WB (14%) and in 4 (3%) 2RBC donors. In WB donors, the mean Hb levels at baseline versus last donation showed no significant difference (153 vs. 152 g/L, = 0.068), whereas the mean ferritin levels decreased significantly (44 vs. 35 μg/L, < 0.001). The 2RBC donor group displayed a statistically different decrease in both the mean Hb levels (158 vs. 157 g/L; < 0.05) and the mean ferritin levels (73 vs. 66 μg/L; = 0.052). The lowest Hb was measured at the 11th WB donation (152 g/L; < 0.05) and at the 4th 2RBC apheresis (157 g/L; < 0.05). There was no deferral due to low Hb at any time. The lowest ferritin was shown at the 4th WB (37 μg/L) and at the 3rd 2RBC donation (60 μg/L), respectively. At the last visit, ferritin was below 15 μg/L in 23 WB donors (8%) and in 2 2RBC donors (1%).
High-intensity male donors with an interdonation interval of 12 weeks for WB donation and 24 weeks for 2RBC apheresis maintain acceptable Hb levels and, after an initial decline, stable ferritin levels despite ongoing blood donation.
高强度献血是献血者缺铁的一个风险因素。各国全血（WB）捐献和双单位红细胞单采（2RBC）的献血间隔有所不同。我们回顾性评估了每年定期捐献4次WB或每年捐献2次2RBC（即最大频率）的男性在48个月期间血红蛋白（Hb）和铁蛋白值的变化过程。
分析了连续捐献16次WB或8次2RBC的男性献血者的数据。WB捐献和2RBC单采（采集360 mL红细胞）的最低Hb水平分别为135 g/L和140 g/L。铁蛋白没有设定下限，也未进行铁补充。
我们确定了294名WB献血者（平均年龄53岁，标准差11）和151名2RBC献血者（平均年龄48岁，标准差9），他们在2008年1月1日至2013年12月31日期间，献血间隔分别平均为97天（标准差18）和201天（标准差32）。基线时，WB献血者的Hb和铁蛋白值低于2RBC献血者，平均Hb分别为153 g/L（标准差13）和159 g/L（标准差8），平均铁蛋白分别为44 μg/L（标准差52）和73 μg/L（标准差56；两个参数均P<0.001）。40名WB（14%）和4名（3%）2RBC献血者的铁蛋白低于15 μg/L。在WB献血者中，基线与最后一次献血时的平均Hb水平无显著差异（153 vs. 152 g/L，P = 0.068），而平均铁蛋白水平显著下降（44 vs. 35 μg/L，P<0.001）。2RBC献血者组的平均Hb水平（158 vs. 157 g/L；P<0.05）和平均铁蛋白水平（73 vs. 66 μg/L；P = 0.052）均有统计学差异的下降。最低Hb出现在第11次WB捐献时（152 g/L；P<0.05）和第4次2RBC单采时（157 g/L；P<0.05）。任何时候都没有因Hb低而延期献血的情况。最低铁蛋白分别出现在第4次WB捐献时（37 μg/L）和第3次2RBC捐献时（60 μg/L）。在最后一次随访时，23名WB献血者（8%）和2名2RBC献血者（1%）的铁蛋白低于15 μg/L。
对于WB捐献献血间隔为12周、2RBC单采献血间隔为24周的高强度男性献血者，尽管持续献血，但仍能维持可接受的Hb水平，且在最初下降后铁蛋白水平稳定。
