Phlebotomy patterns in haemochromatosis patients and their contribution to the blood supply

To determine venesection patterns in hereditary haemochromatosis (HC) patients in Christchurch, New Zealand, their contribution to the blood supply, and reasons for deferral.

Review of clinical records of 412 HC patients venesected by the NZ Blood Service at least once during 2009.

Of 275 males and 137 females, 384 had been tested for HFE gene mutations--76% were C282Y homozygotes, 12.8%, C282Y/H63D compound heterozygous, 8.6%, either H63D homozygotes, C282Y heterozygotes or H63D heterozygotes. Small numbers had no detectable mutations, were not iron overloaded but had been venesected for isolated hyperferritiniaemia. 53% were donors. C282Y homozygotes required significantly more venesections than patients of other genotypes. Eligible HC patients donated 3 units/donor/year compared to 1.63/person/year by healthy donors (p<0.001). HC patients contributed 3.4% of whole blood collections in 2009. There were 212 permanent or temporary donation deferrals--common reasons were abnormal liver functions, chronic or malignant disease, or immigration from vCJD risk countries.

HC donors donate at nearly twice the rate of healthy donors but contribute only a small amount to the blood pool. Revision of selection criteria may increase this contribution without compromising blood safety.