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评估常规铁蛋白检测在献血者中的效用:基于医院的献血者中心经验。

Evaluating utility of routine ferritin testing in blood donors: A hospital-based blood donor centre experience.

作者信息

Petersen Philip, Hakimjavadi Hesamedin, Chamala Srikar, Mathur Gagan

机构信息

Department of Pathology, University of Southern California, Los Angeles, California, USA.

Department of Pathology & Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.

出版信息

Transfus Med. 2024 Dec;34(6):491-498. doi: 10.1111/tme.13081. Epub 2024 Aug 25.

Abstract

BACKGROUND AND OBJECTIVES

Iron deficiency (ID) poses a prevalent concern among blood donors, especially impacting young donors, premenopausal females and frequent donors. In alignment with recommendations to address ID, routine ferritin testing was implemented in a hospital-based donor centre.

MATERIALS AND METHODS

Data set, encompassing 26 164 ferritin values from 16 464 blood donors over 33 months, were analysed retrospectively. Ferritin levels were assessed concerning donor characteristics such as sex, age, ethnicity and donation frequency.

RESULTS

Ferritin testing revealed age, sex and ethnicity variations, emphasising the heightened risk of ID in young females meeting all donation criteria under 23 year of age who demonstrated the lowest mean baseline ferritin (41% [CI: 34%-48%] < 26 ng/mL; 20% [CI: 14%-25%] < 15 ng/mL). Postmenopausal females exhibited ferritin levels similar to similarly aged males. Irrespective of sex, donors showcased mean ferritin recovery within 6 months. Analysis of ferritin recovery post-donation showed a five-fold increase in risk (compared with first visit) of ID when donors return at a 2-month interval. 'Regular' donors (≥10 visits) approach a median steady ferritin level (~30-35 ng/mL) by the sixth visit.

CONCLUSION

As reliance on regular blood donors increases, donation policies must strike a balance between blood centre resources and the risks posed to both regular and at-risk donors. Frequent blood donation led to donors attaining a mean steady state ferritin level above the threshold for ID. At-risk groups, particularly premenopausal females, were several times more likely to experience ID after donation but demonstrated recovery rates similar to their group's baseline levels. This valuable information informed the development of new donor deferral policies.

摘要

背景与目的

缺铁(ID)是献血者中普遍存在的问题,尤其对年轻献血者、绝经前女性和频繁献血者影响较大。为响应解决缺铁问题的建议,一家医院的献血中心实施了常规铁蛋白检测。

材料与方法

回顾性分析了33个月内16464名献血者的26164个铁蛋白值数据集。根据献血者的性别、年龄、种族和献血频率等特征评估铁蛋白水平。

结果

铁蛋白检测显示出年龄、性别和种族差异,强调了23岁以下符合所有献血标准的年轻女性缺铁风险更高,她们的平均基线铁蛋白最低(41%[CI:34%-48%]<26 ng/mL;20%[CI:14%-25%]<15 ng/mL)。绝经后女性的铁蛋白水平与同龄男性相似。无论性别如何,献血者在6个月内铁蛋白平均恢复。对献血后铁蛋白恢复情况的分析表明,当献血者每隔2个月返回献血时,缺铁风险(与首次就诊相比)增加了五倍。“定期”献血者(≥10次献血)到第六次献血时,铁蛋白水平接近中位数稳定水平(约30-35 ng/mL)。

结论

随着对定期献血者的依赖增加,献血政策必须在血库资源与定期献血者和高危献血者面临的风险之间取得平衡。频繁献血使献血者的铁蛋白平均稳态水平达到缺铁阈值以上。高危人群,特别是绝经前女性,献血后缺铁的可能性高出几倍,但恢复率与该组基线水平相似。这些有价值的信息为制定新的献血延期政策提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04e7/11653056/161d732b93a6/TME-34-491-g003.jpg

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