Ferritin-Guided Blood Donation: A Better Way to Prevent Anemia in Blood Donors?

Whole blood donations increase the risk for iron-deficiency anemia. Current selection of donors relies on hemoglobin values, which do not account for depletion of iron reserves. This Dutch study (FIND'EM) aimed to evaluate how using ferritin-guided donation intervals affects donor health and overall blood supply.

The country's 138 donation centers were cluster-randomized to transition sequentially over 2 years from the standard hemoglobin-based screening to a ferritin-guided donation interval policy. Ferritin levels were measured in all new donors and at every fifth donation for repeat donors. Donation intervals (normally, 56 days for men and 122 days for women) were extended to 6 months when donors had ferritin levels of 15 to 30 ng/mL and to 12 months for levels under 15 ng/mL.

Researchers measured ferritin levels in 37,621 samples obtained from 36,099 donors over 38 months. Compared with hemoglobin-based screening, ferritin-guided screening was associated with significantly greater mean ferritin concentrations at 38 months (increases: men, 1.51 ng/mL; premenopausal women, 1.26 ng/mL; postmenopausal women, 1.48 ng/mL) and mean hemoglobin concentrations (increases: 0.30 g/dL, 0.12 g/dL, and 0.16 g/dL, respectively). Iron deficiency also decreased significantly (odds ratios: 0.24, 0.49, and 0.24, respectively). Deferrals based on hemoglobin levels decreased significantly only in men (OR, 0.21). Odds that men and postmenopausal women would return to donate were lower after the intervention than preintervention.