Observational studies suggest large numbers of blood donors experience iron deficiency following previous donation. The current deferral period for donating red cells is 56 days. In the Hemoglobin and Iron Recovery Study, or HEIRS, funded by the National Heart, Lung, and Blood Institute, researchers conducted a randomized trial to evaluate the impact of iron supplementation given to blood donors on hemoglobin recovery post-donation. Donors were randomized to receive daily iron supplementation at a dose of 38 mg or no iron for 24 weeks following blood donation.
Here is Dr. Joseph Kiss, who led the trial:
“The main finding was that hemoglobin recovery was slower than most would think. So we found that the normal blood donor group or iron replete, took an average of 78 days to recover back to within 80 percent of their baseline hemoglobin level. If they were iron deficient, it took them 158 days to recover. If they were randomized to iron, the group that was iron deficient recovered in 32 days and the group that was not iron deficient recovered in 31 days.”
The research team found in addition to the delayed hemoglobin recovery, it took the iron replete donors more than 168 days for ferritin recovery. However, iron supplementation was able to accelerate both hemoglobin and ferritin recovery.
Again, here is Dr. Kiss:
“So the implication is that increasing the deferral period, one of the proposed solutions, will help some donors, but is probably not going to help the majority of donors because recovery of ferritin levels still takes a fair bit of time and if you have someone actively donating they may remain iron deficient over time.”
The study further suggested that to be fully effective, iron supplementation would need to be provided for 90 days, which is longer than most current iron replenishment programs recommend.
Again here is Dr. Kiss:
“I think blood centers will have to decide overall where to place the emphasis – meaning who should receive iron, how much, and for how long. The results of HEIRS suggest that many donors would benefit from a small dose for 90 days, but taking iron in and of itself is logistically challenging, and there are some who will have side effects.”
Thank you for joining us. We’ll be back on November 15th with another edition of Transfusion News.
1. Kiss J, Cable R, Brambilla D, Glynn S, Mast A, Spencer B, Stone M, Tobler L. Hemoglobin Recovery After Blood Donation and the Effects of Iron Suppplementation: The Hemoglobin and Iron Recovery Study (HEIRS). Abstract Presentations from the AABB Annual Meeting and CTTXPO, Denver, CO. October 12-15, 2013. Transfusion 2013;53 Supplement