The effect of a standardized protocol for iron supplementation to blood donors low in hemoglobin concentration

Iron deficiency leading to low hemoglobin concentration (cHb) is a common problem for blood donors as well as for blood banks. A standardized protocol offering iron supplementation based on P-ferritin determination may help to reduce the problem and retain donors.

This was a prospective study where 879 blood donors, presenting with cHb at or below the limit of acceptance for donation, were included. The predonation cHb result was read after donation. The donors received 50 iron tablets (JernC or Ferrochel, 100 or 25 mg elemental iron, respectively), and samples for P-ferritin, mean corpuscular volume, and control of cHb were secured. Based on a P-ferritin level of less than 60 microg per L, 20 iron tablets were offered after all following donations.

Mean cHb was 7.6 mmol per L (122 g/L) and 8.2 mmol per L (132 g/L) in women and men, respectively. In 80 percent of the women and 48 percent of the men, iron stores were low (P-ferritin < or = 30 microg/L). In the donors returning once or twice, an increase in cHb and P-ferritin was seen. Fifteen donors were permanently deferred due to disease and 36 due to low cHb, but 2 years after the start of the study, 79 percent of the women and 85 percent of the men were still active donors.

A standardized protocol offering iron supplementation and simple oral and written advice based on P-ferritin measurements is effective in normalizing cHb and retaining donors presenting with cHb at or below the limit of acceptance for donation.