Platelet Donation by Apheresis for Female Blood Donors with Low Hemoglobin or Iron Deficiency

In Switzerland, platelet (PLT) donation is allowed with hemoglobin (Hb) ≥110 g/L and ≥120 g/L for women and men, respectively. We report on a policy of proposing PLT apheresis to female donors no longer eligible for whole blood (WB) donation because of low Hb and/or iron deficiency.

We assessed 85 women with Hb <125 g/L and/or ferritin ≤ 15 µg/L who changed to PLT apheresis between 01/1997 and 12/2023 and underwent at least one PLT apheresis/year. Hb and ferritin were evaluated at the first WB donation, at the first and last PLT apheresis and were estimated as adjusted values over 30 PLT donations. Donor retention over a 24-month period was evaluated.

The switch to PLT apheresis occurred after a median of 3 (range: 1-33) WB donations. In 42 women (49%), both Hb and ferritin were low, 32 (38%) had low ferritin, and 11 (13%) low Hb only, respectively. Median age (range) at first WB donation and at last PLT donation was 30 years (18-53 years) and 45 years (19-68 years), respectively. Median (range) Hb and ferritin were 134 g/L (120-153 g/L) and 24 µg/L (2-177 µg/L) at the first WB donation and 130 g/L (103-154 g/L) and 14.5 µg/L (3-113 µg/L) at the last PLT apheresis. Over the course of 30 PLT donations and adjusted for donor age, an increasing trend was observed for both Hb (mean + 0.26 g/L; 95% CI: 0.16, 0.35; p < 0.001) and ferritin (mean + 0.48 µg/L; 95% CI: 0.21, 0.75; p < 0.001). At the end of a 24-month period, 94% (95% CI: 86.4%, 97.5%) women were still donating.

Women with low Hb and/or iron deficiency benefit from a change to PLT donation and can be retained as regular, highly committed PLT donors.