Iron Management in Blood Donation Systems

Effective management of iron stores in blood donors is critical to safeguarding donor health and ensuring sustainable blood supplies. Repeated phlebotomy reduces systemic iron, reflected in declining ferritin and haemoglobin levels, which can lead to iron deficiency and deferral from donation. Contemporary approaches address these risks through donor screening, personalised donation intervals, point-of-care ferritin measurement and targeted supplementation. Integrating predictive modelling with biochemical monitoring enables services to stratify donors by risk, adjust inter-donation intervals and counsel on diet or iron therapy. Globally, harmonising these strategies can reduce donor attrition, maintain safe donation thresholds and optimise the availability of blood products without compromising donor well-being.

Research from Nature Portfolio

A recent study developed and validated a multivariable prediction model for iron status using questionnaire-derived factors such as dietary intake, supplement use and donation history in a large women’s cohort. While prediction of serum iron and transferrin saturation remained modest, the model achieved improved performance for ferritin, particularly when menopausal status was incorporated. This work highlights the challenges of noninvasive iron assessment and the influence of biological heterogeneity, pointing towards hybrid strategies that combine questionnaire data with selective biochemical testing to refine donor management protocols.

Iron Management in Blood Donation Systems publication trend

The graph below shows the total number of articles in iron management in blood donation systems across all publications each year (not limited to Nature Index journals).

Technical terms

Ferritin: An intracellular protein that reflects total body iron stores and is measured in serum to assess iron status.

Haemoglobin: The oxygen-carrying protein in red blood cells whose concentration indicates anaemia or iron deficiency.

Transferrin saturation: The percentage of the iron-binding protein transferrin that is occupied by iron, used as a marker of iron availability.

Point-of-care testing: Diagnostic testing conducted at or near the site of patient care, enabling rapid decision-making.

Ferritin-guided donation intervals: A policy approach in which donation frequency is adjusted based on measured ferritin thresholds to prevent iron depletion.

References

1. Development and validation of a prediction model for iron status in a large U.S. cohort of women. Scientific Reports (2023).
2. Using Capillary Whole Blood to Quantitatively Measure Ferritin: A Validation Trial of a Point-of-Care System. Nutrients (2023).
3. Ferritin measurement IN Donors—Effectiveness of iron Monitoring to diminish iron deficiency and low haemoglobin in whole blood donors (FIND’EM): study protocol for a stepped wedge cluster randomised trial. Trials (2020).
4. Efficiency and safety of varying the frequency of whole blood donation (INTERVAL): a randomised trial of 45 000 donors. The Lancet (2017).