scholarly journals Ferritin trajectories over repeated whole blood donations: results from the FIND+ study

2021 ◽  
Author(s):  
Sara Moazzen ◽  
Maike sweegers ◽  
Brois Hogema ◽  
Trynke Hoekstra ◽  
Katja van den Hurk
Keyword(s):  
Whole Blood ◽  
Mixed Models ◽  
Iron Supplementation ◽  
Blood Donors ◽  
Ferritin Level ◽  
Growth Mixture Models ◽  
Iron Stores ◽  
Growth Mixture ◽  
Observational Cohort

Abstract Background: Whole blood donors lose approximately 200-250 mg of iron per donation. Depending on post-donation erythropoiesis, available iron stores, and iron absorption rates, optimal donation intervals may differ between donors. This project aims to define subpopulations of donors with different ferritin trajectories over repeated donations. Methods: Ferritin levels of 300 new whole blood donors were measured from stored (lookback) samples from each donation over a two-year period in an observational cohort study. Latent classes of ferritin level trajectories were investigated using growth mixture models for male and female donors, separately. Associations of ferritin levels with subsequent iron deficiency and/or low haemoglobin were assessed with generalized linear mixed models. Results: In both genders two groups of donors were identified using group-based trajectory modelling. Ferritin levels showed rather linear reductions among 42.9% of male donors and 87.7% of female donors. For the remaining groups of donors, steeper declines in ferritin levels were observed. Ferritin levels at baseline and the end of follow-up varied greatly between groups. Conclusion: Repeated ferritin measurements show depleting iron stores in all new whole blood donors, the level at which mainly depends on baseline ferritin levels. Tailored, less intensive donation strategies might help to prevent low iron in donors, and could be supported with ferritin monitoring and/or iron supplementation.

scholarly journals Identification and prediction of novel classes of long-term disease trajectories for patients with juvenile dermatomyositis using growth mixture models

Rheumatology ◽  
2020 ◽  
Author(s):  
Claire T Deakin ◽  
Charalampia Papadopoulou ◽  
Liza J McCann ◽  
Neil Martin ◽  
Muthana Al-Obaidi ◽  
...  
Keyword(s):  
Disease Activity ◽  
Mixture Models ◽  
Clinical Features ◽  
Lasso Regression ◽  
Growth Mixture Models ◽  
Growth Mixture ◽  
Class 1 ◽  
Time Since Diagnosis

Abstract Objectives Uncertainty around clinical heterogeneity and outcomes for patients with JDM represents a major burden of disease and a challenge for clinical management. We sought to identify novel classes of patients having similar temporal patterns in disease activity and relate them to baseline clinical features. Methods Data were obtained for n = 519 patients, including baseline demographic and clinical features, baseline and follow-up records of physician’s global assessment of disease (PGA), and skin disease activity (modified DAS). Growth mixture models (GMMs) were fitted to identify classes of patients with similar trajectories of these variables. Baseline predictors of class membership were identified using Lasso regression. Results GMM analysis of PGA identified two classes of patients. Patients in class 1 (89%) tended to improve, while patients in class 2 (11%) had more persistent disease. Lasso regression identified abnormal respiration, lipodystrophy and time since diagnosis as baseline predictors of class 2 membership, with estimated odds ratios, controlling for the other two variables, of 1.91 for presence of abnormal respiration, 1.92 for lipodystrophy and 1.32 for time since diagnosis. GMM analysis of modified DAS identified three classes of patients. Patients in classes 1 (16%) and 2 (12%) had higher levels of modified DAS at diagnosis that improved or remained high, respectively. Patients in class 3 (72%) began with lower DAS levels that improved more quickly. Higher proportions of patients in PGA class 2 were in DAS class 2 (19%, compared with 16 and 10%). Conclusion GMM analysis identified novel JDM phenotypes based on longitudinal PGA and modified DAS.

scholarly journals FinDonor 10 000 study: A cohort to identify iron depletion and factors affecting it in Finnish blood donors

2018 ◽  
Author(s):  
Jukka Partanen ◽  
Pia Niittymäki ◽  
Nina Nikiforow ◽  
Elina Palokangas ◽  
Muriel Lobier ◽  
...  
Keyword(s):  
Whole Blood ◽  
Blood Donors ◽  
Iron Status ◽  
Time Lag ◽  
Time Of Day ◽  
Cool Temperature ◽  
Factors Affecting ◽  
Iron Stores ◽  
Increased Risk ◽  
Donation Frequency

AbstractBackground and ObjectivesThere is increasing evidence that frequent blood donation depletes the iron stores of some blood donors. The FinDonor 10 000 study was set up to study iron status and factors affecting iron stores in Finnish blood donors. In Finland, iron supplementation for at-risk groups has been in place since the 1980’s.Material and Methods2584 blood donors (N= 8003 samples) were recruited into the study alongside the standard donation at three donation sites in the capital region of Finland between 5/2015 and 12/2017. All participants were asked to fill out a questionnaire about their health and lifestyle. Blood samples were collected from the sample pouch of whole blood collection set, kept in cool temperature and processed centrally. Whole blood count, CRP, ferritin and sTFR were measured from the samples and DNA was isolated for GWAS studies.ResultsParticipant demographics, albeit in general similar to the general blood donor population in Finland, indicated some bias toward older and more frequent donors. Participation in the study increased median donation frequency of the donors. Analysis of the effect of time lag from the sampling to the analysis and the time of day when sample was drawn revealed small but significant time-dependent changes.ConclusionThe FinDonor cohort now provides us with tools to identify potential donor groups at increased risk of iron deficiency as factors explaining this risk. The increase in donation frequency during the study suggests that scientific projects can be used to increase the commitment of blood donors.

scholarly journals Effect of blood donation on iron stores as evaluated by serum ferritin

Blood ◽  
1977 ◽  
Vol 50 (3) ◽  
pp. 441-447 ◽  
Author(s):  
CA Finch ◽  
JD Cook ◽  
RF Labbe ◽  
M Culala
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Blood Donors ◽  
Serum Ferritin Level ◽  
Blood Donation ◽  
Ferritin Level ◽  
Geometric Mean ◽  
Iron Stores ◽  
High Incidence ◽  
First Time

Serum ferritin was measured in 2982 blood donors. First-time male donors had a geometric mean of 127 microgram/liter and female donors 46 microgram/liter. While values were essentially constant in the women between the ages of 18 and 45, there was a rapid increase in the men between 18 and 30 years of age consistent with the establishment of iron stores during that time. Blood donation was associated with a decrease in serum ferritin. One unit per year, equivalent to an increased requirement of 0.65 mg/day, halved the serum ferritin level in the male. More frequent donations were associated with further decreases. From the data obtained it would appear that male donors, while depleting their iron stores, were able to donate 2–3 U/yr without an appreciable incidence of iron deficiency. Women could donate only about half that amount, and more frequent donations were associated with a high incidence of iron deficiency and donor dropout. These data have provided information on the effect of graded amounts of iron loss through bleeding on iron balance.

scholarly journals Determinants of ferritin response to oral iron supplementation in children with sleep movement disorders

SLEEP ◽  
2019 ◽  
Author(s):  
Lourdes M DelRosso ◽  
Troy Yi ◽  
Jeremy H M Chan ◽  
Joanna E Wrede ◽  
Carey T Lockhart ◽  
...  
Keyword(s):  
Side Effects ◽  
Iron Supplementation ◽  
Chart Review ◽  
Ferritin Level ◽  
Retrospective Chart Review ◽  
Oral Iron ◽  
Periodic Limb Movements ◽  
Obstructive Sleep ◽  
Nocturnal Polysomnography

Abstract Study Objectives To identify children who respond to oral iron supplementation as evidenced by increased ferritin levels and to identify factors that correlate with improvement in ferritin levels in those who respond. Methods A retrospective chart review of the PLMS/RLS/RSD database at Seattle Children’s Hospital was carried out. Data collected included nocturnal polysomnography parameters, age, sex, initial and follow-up ferritin level and date of collection, and presence of restless legs syndrome (RLS), periodic limb movements of sleep (PLMS)/PLM disorder (PLMD), restless sleep disorder (RSD), obstructive sleep apnea (OSA), neurologic, psychiatric, neurodevelopmental, or medical comorbidity. Oral iron therapy was evaluated by side effects (none; constipation; bad taste/nausea), subjective outcome in symptoms (resolved, improved, no change), and adherence to therapy (poor, fair, good). Results Seventy-seven children were included in this study of whom 42 were classified as responders (increase in ferritin of ≥10 µg/L) and 35 were nonresponders. Age and sex were not different between groups. Adherence was the only significant predictor of an increase in ferritin of ≥10 µg/L. Constipation was seen in 7.1% of responders vs. 45.8% of nonresponders. No change in symptoms was reported in 26.2% of responders vs. 71.4% in nonresponders. A significant correlation was found between treatment duration and ferritin level change in responders but not in nonresponders Conclusions Side effects hinders adherence to oral iron supplementation in children. Responders to oral iron show improvement in ferritin levels and symptoms, while nonresponders show no improvement in ferritin levels despite a long-lasting treatment, at least in part of them.

scholarly journals Effect of iron supplementation on iron stores and total body iron after whole blood donation

Transfusion ◽  
2016 ◽  
Vol 56 (8) ◽  
pp. 2005-2012 ◽  
Author(s):  
Ritchard G. Cable ◽  
Donald Brambilla ◽  
Simone A. Glynn ◽  
Steven Kleinman ◽  
Alan E. Mast ◽  
...  
Keyword(s):  
Whole Blood ◽  
Iron Supplementation ◽  
Blood Donation ◽  
Body Iron ◽  
Iron Stores ◽  
Total Body

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

Transfusion ◽  
2017 ◽  
Vol 57 (8) ◽  
pp. 1922-1929 ◽  
Author(s):  
Sant-Rayn Pasricha ◽  
Denese C. Marks ◽  
Hannah Salvin ◽  
Tania Brama ◽  
Anthony J. Keller ◽  
...  
Keyword(s):  
Whole Blood ◽  
Blood Donors ◽  
Feasibility Studies ◽  
Iron Stores ◽  
Iron Replacement

scholarly journals Post-donation telephonic interview: A tool for active follow-up of voluntary whole blood donors for analysis of frequency and predisposing factors of adverse reactions

2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Anisha Navkudkar ◽  
Priti Desai ◽  
Sunil Rajadhakshaya
Keyword(s):  
Blood Supply ◽  
Whole Blood ◽  
Blood Donors ◽  
Adverse Reactions ◽  
Blood Donation ◽  
Positive Impact ◽  
Tertiary Care ◽  
Statistical Tool ◽  
Donor Safety

Objectives: Blood donation experience by most donors is satisfactory; however, a few may encounter adverse reactions. Healthy, altruistic, voluntary blood donors ensure adequate blood supply despite the potential risk of adverse reactions. Post-donation follow-up is crucial to get information about these adverse reactions. This study aimed to evaluate the frequency and type of adverse donor reactions and their correlation with contributory factors if any among the blood donors in a tertiary care oncology center. Material and Methods: It was a prospective observational study of 1000 consecutive voluntary whole blood donors who consented to participate in the study. Donors were followed up telephonically on two instances (first after 24 h of donation and second after 2 weeks of donation) and were asked a self-structured donor questionnaire to collect information regarding the adverse donor reactions if any. An appropriate statistical tool was used for analysis (IBM, SPSS software). Results: Of the 1000 voluntary whole blood donors, 92.6% (926/1000) responded to telephonic calls on both occasions. Of these 926, 8.5% (79/926) donors experienced adverse reactions. All these donors experienced immediate reactions, that is, within 24 h of donation while none reported fresh adverse reactions beyond 24 h–2 weeks. Of the 79 donors, 60% (49/79) experienced vasovagal reactions (VVR) and 40% (32/79) experienced hematoma including two donors who experienced both. A total of 86% (68/79) of reactions occurred in outdoor blood donation camps while 14% (11/79) occurred in-house (indoor). First time donors, female donors, and donors with weight on the lower side were more prone to immediate VVR (P < 0.05). Of the 49 VVR, 76% (37/49) were mild, 18% (9/49) were moderate, and 6% (3/49) were severe. Most of the hematomas, that is, 90% (29/32) occurred at outdoor blood donation camps while 10% (3/32) occurred indoor. Most hematomas (53%) took more than 7 days to recover. Conclusion: Post-donation interview proves to be an efficient tool to acquire information about adverse donor reactions. This will help in improving donor safety and satisfaction and will have a positive impact on the national blood supply by improving the donor return rate. Blood transfusion services (BTSs) staff must be trained to promptly identify the donor reactions onsite and manage them to enhance the donation experience of voluntary donors. Post-donation follow-up will aid in getting the donation experience and BTS can develop strategies to enhance it. This will also help in donor hemovigilance in the future for the betterment of donor safety.

Repeat whole blood donors with a ferritin level of 30 μg/L or less show functional iron depletion

Transfusion ◽  
2018 ◽  
Vol 59 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Angelique Dijkstra ◽  
Katja van den Hurk ◽  
Henk J. G. Bilo ◽  
Robbert J. Slingerland ◽  
Michel J. Vos
Keyword(s):  
Whole Blood ◽  
Blood Donors ◽  
Ferritin Level ◽  
Iron Depletion

Superdonors Have Decreased Iron Stores but Can Repeatedly Donate Whole Blood through Use of Iron Supplements and Decreased Serum Hepcidin Concentration.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2887-2887
Author(s):  
Alan E. Mast ◽  
Tisha Foster ◽  
Holly L. Pinder ◽  
Craig A. Beczkiewicz ◽  
Daniel B. Bellissimo ◽  
...  
Keyword(s):  
Polycythemia Vera ◽  
Whole Blood ◽  
Blood Donors ◽  
Iron Absorption ◽  
Blood Donation ◽  
C282y Mutation ◽  
Iron Supplements ◽  
Expected Frequency ◽  
Iron Stores ◽  
Serum Hepcidin

Abstract Examination of the low hematocrit (HCT) deferral rates in whole blood donors based on gender/menstrual status and donation intensity unexpectedly revealed that low HCT deferral rates level off and even begin to decrease in frequent donors (>8 donations in 2 years) suggesting that frequent blood donors are a self-selected population possessing either behavioral or biochemical characteristics that allow greater iron absorption than the general population. To define these characteristics, 138 donors (101 male, 37 female, 136 Caucasian) that had donated 13 times in a 2-year period (“superdonors”) completed a questionnaire and had a blood sample analyzed for ferritin, hepcidin and HFE and JAK-2 genotypes. Ferritin was 31.0±20.3 ug/L for males and 25.2±14.8 ug/L for females. Two-thirds of both men and women had ferritin below 30 ug/L indicating that most have reduced iron stores. Average ferritin was ∼15 ug/L higher in donors taking multiple vitamins with iron or iron supplements than in those who did not take them. Hepcidin is an iron regulatory hormone that negatively regulates intestinal iron absorption. Serum hepcidin levels were determined using a liquid chromatography tandem mass spectrometry assay. The normal serum hepcidin concentration using this assay is 8–11 ng/ml [Blood110:1048 (2007)]. Serum hepcidin was greatly decreased in superdonors (males 2.9±5.4 ng/ml; females 2.8±2.7 ng/ml) and 55 had no detectable hepcidin (<1 ng/ml), suggesting that superdonors absorb maximal amounts of intestinal iron. The C282Y mutation in the HFE gene has been linked to unregulated iron absorption and the development of hemochromatosis. This mutation was analyzed to determine if heterozygosity is present at greater than expected frequency in superdonors. It is present in 21 (15.2%) of the superdonors. This is higher than the reported frequency of 10–12% in Caucasians but did not reach statistical significance. The JAK-2 mutation is strongly associated with polycythemia vera and other myeloproliferative disorders. None of the superdonors had this mutation. In summary, superdonors are able to frequently donate whole blood with a lower than expected frequency of low HCT deferral despite having very low iron stores. Many, but not all, superdonors take either multiple vitamins with iron or an iron supplement that partially accounts for their ability to repeatedly meet the HCT requirement for whole blood donation. A key biochemical characteristic of superdonors that also contributes to their ability to repeatedly donate whole blood is greatly reduced serum hepcidin concentration that allows maximal intestinal iron absorption. Genetic analyses revealed that there is a trend towards an increased prevalence of heterozygosity for the C282Y mutation that may allow some superdonors to efficiently absorb intestinal iron and donate frequently without low HCT deferral, but no evidence for presence of the JAK-2 mutation indicating that undiagnosed polycythemia vera is not a common cause for successful repeated blood donation by superdonors.

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