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Iron Repletion Does Not Effect Donor Well-Being or Red Cell Quality

September 28, 2022

Iron deficiency develops in over one third of regular, repeat blood donors.  In order to exam the physiological consequences of iron deficiency in blood donors, a randomized, double-blind, placebo-controlled trial (Donor Iron Deficiency Study [DIDS]) screened 2,011 adult blood donors.  Of these, 110 met the criteria for iron deficiency (ferritin <15 µg/L and zinc protoporphyrin >60 µMol/mol heme) but were still eligible to donate.  In total, 79 subjects were enrolled and donated an initial whole blood unit that was stored for 40-42 days and tested for blood quality using the standard—51-chromium post transfusion recovery.   Subjects were than randomized within 30 days to receive either one gram of low molecular weight iron dextran (n=39) or saline placebo (n=40) intravenously.  A second autologous whole blood donation was then scheduled approximately 150 days following randomization, and a second 51-chromium post-transfusion recovery study was performed after 40-42 days of storage.  Iron deficiency did not affect either the post-transfusion recovery of the RBCs; the mean change in post-transfusion recovery was 1.6% (95% C.I., -0.5 to 3.8) and -0.4% (95% C.I., -2.0 to 1.2) with and without iron, respectively.  Furthermore, iron deficiency did not affect the cognition or well-being of donors based on the National Institutes of Health’s Cognition Fluid Cognition Fluid Composite Score nor other secondary tests.  RBCs from iron deficient donors did not affect the post-transfusion recovery of the RBCs in recipients nor the well-being of the donors.

Reference:

Hod EA, Brittenham GM, Bitan ZC, Feit Y, et al.  A randomized trial of blood donor iron repletion on red cell quality for transfusion and donor cognition and wellbeing.  Blood 2022

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