Screening for hemosiderosis in patients receiving multiple red blood cell transfusions

Area of Science:

• Hematology
• Transfusion Medicine
• Iron Metabolism

Background:

• Hemosiderosis significantly impacts survival in chronically transfused hereditary anemia patients.
• Adequate screening for hemosiderosis in patients receiving multiple red blood cell (RBC) transfusions requires evaluation.

Purpose of the Study:

• To assess the adequacy of hemosiderosis screening practices.
• To determine the prevalence of hemosiderosis in transfused adult patients.

Main Methods:

• Retrospective analysis of 471 adult patients receiving over twenty RBC units (2010-2015).
• Defined hemosiderosis as ferritin ≥1000 μg/L.
• Established criteria for adequate screening based on transfusion timing.

Main Results:

• Only 38.6% of patients were adequately screened for hemosiderosis.
• Overall hemosiderosis prevalence was 46.7%.
• Prevalence varied between chronic (47%) and bulk (12%) transfusion groups, and by indication (hematological malignancy: 53%, cardiothoracic surgery: 13%).

Conclusions:

• Current hemosiderosis screening practices are suboptimal.
• Hemosiderosis is a complication beyond hematology wards.
• Universal screening for hemosiderosis in all multiply transfused patients is recommended.