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Decreased levels of ferritin, mild thrombocytosis, and increased erythropoietin are sequential events among frequent plateletpheresis donors: Implication for a ferritin screen

  • Author Footnotes
    1 These authors contributed equally to the present work.
    Li-Te Chin
    Footnotes
    1 These authors contributed equally to the present work.
    Affiliations
    Department of Microbiology, Immunology and Biopharmaceuticals, National Chiayi University, Chiayi City, Taiwan, ROC

    Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
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  • Author Footnotes
    1 These authors contributed equally to the present work.
    Jun Yu Woon
    Footnotes
    1 These authors contributed equally to the present work.
    Affiliations
    Department of Microbiology, Immunology and Biopharmaceuticals, National Chiayi University, Chiayi City, Taiwan, ROC
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  • Sau-Wei Kuo
    Affiliations
    Tainan Blood Center, Taiwan Blood Services Foundation, Tainan, Taiwan, ROC
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  • Shih-Chien Lu
    Correspondence
    Correspondence to: Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, No. 89, Rende Dist., Tainan City 717302, Taiwan, ROC.
    Affiliations
    Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan, Taiwan, ROC

    Tainan Branch, Chinese Blood Donation Association, Tainan, Taiwan, ROC
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  • Author Footnotes
    1 These authors contributed equally to the present work.

      Abstract

      Background

      It is generally recognized that repeat apheresis increases the risk for iron deficiency, thus may impact on the blood homeostasis. With regard to donor vigilance, we clarified the mid- to long-term effects of plateletapheresis by comparing the most frequent donors with the first-time ones in hematological and biochemical tests.

      Methods

      Levels of erythropoietin (EPO), hemoglobin (Hb) and ferritin were analyzed in double-unit (500 mL whole blood or 6 × 1011 apheresis platelets) donations in three male cohorts, with identifiers of first-time whole-blood donors (n = 30), first-time platelet donors transited from maximal whole blood to apheresis (n = 30) and frequent donors subjected to extreme plateletpheresis (n = 90), respectively. According to the number of donations, the last earnest cohort, who donate almost 24 times a year, was further subdivided into three groups– casual (76–120 life-time donations in 5 years), mediocre (121–168 within 7 years) and enthusiastic (≥169 within 7 years and a month).

      Results

      Regardless of the donation experience in whole blood or plateletpheresis, iron deficiency (serum ferritin concentrations <15 μg/L) was identified in all earnest cohorts. The ferritin means were significantly lower in plateletpheresis groups, with the lowest values in the enthusiastic group. EPO levels showed a significant inverse correlation with ferritin (p = 0.015, r = –0.224). Long-term earnest donors had the lowest iron stores accompanied by a later thrombocytosis and a final increase in EPO was revealed.

      Conclusion

      Regular ferritin screens are crucial to ensure a high level of donor health protection.

      Keywords

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