Evaluating the Impact of Ferritin Testing: Iron Status of the Donor Pool, Changes to Hemoglobin Deferrals, and...

Blood collectors in many jurisdictions globally have implemented ferritin testing of their donor populations as an additional donor safety measure. Where performed, ferritin testing is generally conducted on a selective basis, restricted to certain populations perceived to face higher risk for or from iron deficiency or applied to periodic rather than all donations from donors. The wide array of ferritin testing configurations that currently exist, together with underlying differences in donation eligibility policies, suggests the impact of ferritin testing on blood center and donor outcomes-both desired and unfavorable ones-is likely to vary considerably across the blood donation landscape. This review examines available evidence regarding the impact of ferritin testing programs on the iron status of the blood donor pool, on the deferral rate for low hemoglobin, and on blood component availability. It presents results from 4 key papers that illustrate different configurations implemented for ferritin testing, characterizing the impact on blood center efficiency and blood donor outcomes. Original data covering several years of ferritin testing is also presented from a large United States-based blood collector, providing insights into long-term developments and donor response to notification of low-ferritin. Additional research is needed to address long-term outcomes and, especially, donor behavioral changes to address the challenge of maintaining iron levels as a regular blood donor.