Ferritin screening to prevent iron deficiency in whole blood donors

Whole blood donation invokes the risk of iron store depletion; through the haemoglobin (Hb)-bound iron loss, and subsequent increased erythropoiesis. Hb levels are frequently measured to monitor donors, but these levels do not reflect the true iron status. Depleted iron stores could lead to health problems and an increased risk of being deferred for low Hb levels. We anticipate that the implementation of routine ferritin testing in whole blood donors will result in a lower prevalence of iron deficiency and a lower risk of Hb deferrals.

To prevent iron store depletion and low Hb deferrals, a protocol including ferritin screening to improve donors’ iron-related health management will be developed and implemented as part of this project. This protocol will be based on:

• a literature study,
• an assessment of ferritin levels in the Dutch donor population based on data from Donor InSight,
• a cost-effectiveness study in collaboration with ErasmusMC
• a study that evaluates associations of ferritin levels with symptoms of iron deficiency and cognitive functioning, based on Donor InSight data.

The proposed screening strategy will be implemented and evaluated using a stepped wedge cluster randomised trial. This pragmatic design involves random and sequential crossover of clusters (donation centers or regions) from current to new screening strategy, until all clusters are exposed to the new screening strategy.