Abstract Session Points to Risk of Low Iron in Teen Donors

Yes, the last sessions are worth staying for. But if you didn’t, here’s what you missed at one of the last oral abstract sessions at the annual meeting.


High school donors are at greater risk for iron depletion even before starting to donate blood, according to updated results of the Comparison of the History of Donation and Iron Levels in Teen Blood Donors (CHILL) study presented at the 2017 AABB Annual Meeting.


Donors aged 16-18 years have a greater prevalence of iron depletion than adults after controlling for demographics and donation behavior, said Bryan Spencer, PhD, research scientist at ARC and program manager of the Yale/ARC “domestic hub” of the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) program, sponsored by the National Heart, Lung, and Blood Institute. The findings led the researchers to conclude that “blood centers should implement measures to mitigate iron depletion in young donors.”

Both first-time and repeat donors aged 16-18 years average lower ferritin values at enrollment (p<.0001), and a greater percentage were iron-depleted than older donors (19-49 years). The odds for low ferritin (less than 26 ng/mL among high-school donors were 3.3, 4.0 and 4.7 for 18-, 17- and 16-year-olds respectively compared with adults. The odds for absent iron stores (less than 12 ng/mL) were 2.1, 2.8 and 2.6 respectively.


Mitigating Iron Deficiency in Young Donors — Preliminary Experience
One large blood collector has begun intervening to protect young donors from iron deficiency and absent iron stores through serum ferritin testing performed on successful whole blood and apheresis donations from donors aged 16-18 years. Ralph R. Vassallo, MD, reported on preliminary results. Vassallo is the executive vice president and chief medical & scientific officer for Blood Systems, Inc. The intervention was progressively implemented throughout Blood Systems centers between December 2016 and March 2017.


Low ferritin was defined as < 20 ng/mL in females and < 30 ng/mL in males. Donors identified with low ferritin were notified that they were deferred from red blood cell donations — 12 months for females and 6 months for males. They were also advised to take 18-28 mg of elemental iron daily for 60 days.


Successful RBC donations from those aged 16-18 years accounted for almost 10% of the more than 52,000 donations (as of 8/31/17). Young donor ferritin testing identified 28.6% of teen donors with low ferritin, who might benefit from an iron depletion mitigation strategy, Vassallo said. In addition, low ferritin and iron deficiency were more common among female donors and among repeat donors.


Vassallo concluded that “these data may inform AABB’s risk-based decision making exercise to establish recommendations for risk mitigation which may be different for male than for female donors.”


—Kerri Wachter


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