Postdonation iron replacement for maintaining iron stores in female whole blood donors in routine donor practice: results of two feasibility studies in Australia.

Journal article

Background

Iron deficiency represents a risk to donor health and the blood supply. Efficacy trials indicate that post-donation iron-replacement improves iron stores but they do not account for complexities of implementation in the routine collection context. We therefore conducted two prospective feasibility studies in Australian donor centers.

Study Design and Methods

In both studies we recruited female donors between 18 and 45 who had made at least one donation in the previous 12 months. In READ (REplacement ADvice), female donors were given a recommendation to self-procure post-donation iron. In DIRECT (Donor Iron REplaCemenT), donors were provided with a course of iron supplements. Donors could return to donate at their discretion and were surveyed following the recruitment visit and again towards the end of the 13-month follow-up. Donor uptake, adverse effects, effectiveness in maintaining iron stores and workflow impact were assessed.

Results

We recruited 1404 (70.9% of invited) donors to READ and 768 (53.2% of invited) to DIRECT. READ and DIRECT extended pre-donation interviews by 1 and 5 minutes respectively. Among participants, 44% and 88% took iron in READ and DIRECT respectively. Adverse effects were common but usually mild. READ failed to maintain iron stores in the population, but was effective in donors who consumed >75% of the recommended dose. DIRECT was effective in preventing declines in ferritin concentration.

Conclusion

Trade-offs between cost, complexity, uptake and effectiveness must be considered in the implementation of post-donation iron supplementation.

Authors: Pasricha, S; Marks, D; Salvin, H; Brama, T; Keller, A

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Wiley
• Journal: Transfusion
• Volume: 57
• Issue: 8
• Pages: 1922-1929
• Publication date: 2017-05-18
• Acceptance date: 2017-03-28
• DOI: 10.1111/trf.14173
• EISSN: 1537-2995
• ISSN: 0041-1132
• Language: English
• Keywords: implementation; anemia; blood transfusion; Iron deficiency