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反复的单采捐献会导致日本男性捐献者出现严重的缺铁。

Repeated apheresis donations cause important iron deficiency in male Japanese donors.

机构信息

Japanese Red Cross Central Blood Institute, Tokyo, Japan.

Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan.

出版信息

Vox Sang. 2024 Nov;119(11):1141-1149. doi: 10.1111/vox.13720. Epub 2024 Aug 12.

Abstract

BACKGROUND AND OBJECTIVES

In Japan, apheresis donation of plasma is allowed to a maximum of 24 times a year, and plateletpheresis are counted as two plasmapheresis donations. Diversion of the initial blood flow is conducted for all donations, and additionally, blood remaining in apheresis machine circuit is lost. Here, we aimed to investigate on the health impact of frequent apheresis donations, as measured by the serum ferritin (sFer).

MATERIALS AND METHODS

A total of 538 male apheresis donors and 538 age-matched whole blood (WB) donors, who gave informed consent to join the study, were enrolled. sFer were compared, according to age. Another group of 19 apheresis donors were followed during four consecutive donations.

RESULTS

About half (48%) of repeat male apheresis donors had iron deficiency (sFer < 26 ng/mL), compared with lower rates (13.9%) among male WB donors. It was evident in all age groups, except for teenagers, possibly because of the lower number of donations. Follow-up of the 19 donors for 4 months revealed a progressive decrease in sFer.

CONCLUSION

Blood remaining in the apheresis machine circuit and diversion of the initial blood flow have been implicated in iron deficiency for many years. Taking the present results, the manufacturer of apheresis equipment was requested to improve it to allow rinseback of the remaining blood, which was achieved only for plateletpheresis. Until further improvement, plasmapheresis frequency was reduced to 12 times a year. Additional measures, such as oral supplementation of iron, need to be considered.

摘要

背景与目的

在日本,每年最多可进行 24 次血浆单采术捐献,血小板单采术算作 2 次血浆单采术捐献。所有捐献均进行初始血流分流,并且采集机会损失部分机器内的血液。在此,我们旨在通过血清铁蛋白(sFer)来研究频繁采集对健康的影响。

材料与方法

共纳入 538 名男性采集捐献者和 538 名年龄匹配的全血(WB)捐献者,他们均同意加入该研究。根据年龄比较 sFer。对 19 名采集捐献者进行了连续 4 次采集的随访。

结果

与男性 WB 捐献者(13.9%)相比,约一半(48%)重复男性采集捐献者存在缺铁(sFer<26ng/mL)。除青少年外,在所有年龄组中都有明显表现,这可能是由于采集次数较少。对 19 名捐献者进行了 4 个月的随访,发现 sFer 逐渐下降。

结论

多年来,采集机器内的剩余血液和初始血流分流一直被认为与缺铁有关。鉴于目前的结果,我们要求采集设备制造商进行改进,以允许冲洗剩余血液,但仅对血小板采集术实现了这一改进。在进一步改进之前,将血浆采集频率减少到每年 12 次。需要考虑其他措施,如口服补铁。

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