Eat your green veggies! Have a steak every now and then, for goodness’ sake!” We’ve been telling blood donors things like that for decades, but is that advice really helpful? Dr. Jed Gorlin explains the recent, troubling data on iron and blood donors.

Jed Gorlin, MD

Dr. Jed Gorlin

In recent years, several excellent studies have demonstrated pretty clearly that blood donors have limited iron stores, and that the process of blood donation impacts those stores pretty dramatically. This is particularly true in several very well-defined groups of donors, including: Frequent whole blood donors (males donating more than three times in a year, females more than twice per year), premenopausal females, and young donors (especially teenagers) of both sexes. In the United States, donors may give blood every 8 weeks (up to 5 or 6 times per year), and up until 2016, males and females had the same qualifying hemoglobin (12.5 g/dL, or 125 g/L) to determine their eligibility (NOTE: The U.S. threshold was adjusted upward to 13.0 g/dL for males in 2016). Many other countries are more restrictive, and the topic of iron status of our blood donors is a very “hot” one right now!

So What do we Do?

This is an extremely important discussion, as blood centers everywhere are struggling with decreased collections. It is tempting to depend on donors in certain “easy to collect” groups, and those include donors at high risk outlined above! So, what to do? Dr. Gorlin has been heavily involved in these discussions, and he brings a unique perspective to this interview. He describes the relevant studies (linked in the “Further Reading” section below), and walks us through the steps that blood collectors (and donors) should take right away.

About My Guest:

Dr. Jed Gorlin received his BS from Stanford and his MD from Yale. He is board-certified in Pediatrics and Blood Banking/Transfusion Medicine. He is Medical Director and Vice President, Quality and Regulatory Affairs at Innovative Blood Resources. Jed’s duties include Memorial Blood Centers in Minnesota, Nebraska Community Blood Bank, the Community Blood Center of Greater Kansas City in Kansas City, MO. He has served in various leadership roles with AABB through his more than 20 years in Transfusion Medicine, including Chair of the Standards Committee for the 20th and 21st editions of AABB Standards, and as an AABB board member. He is a chapter contributor to 21 published books and anthologies, and author or co-author of over 120 published papers and abstracts.

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DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. Gorlin nor I have any financial disclosures relevant to this discussion.

The images below are generously provided by Dr. Gorlin.

Slide 1 - International comparison of donor HGB thresholds and intervals (note: US and Canada have updated in 2016)
Slide 2 - RISE study data showing near universal iron deficit in female frequent donors (labeled ("RPT")
Slide 3 - RISE data showing predictably lower ferritin levels with increased donations in both sexes
Slide 4 - Nov 2011 FDA donor iron workshop discussions summarized
Slide 5 - AABB Bulletin 12-03 development
Slide 6 - AABB Bulletin 12-03 specific recommendations
Slide 7 - HEIRS results. Iron stored recovered faster with iron replacement
Slide 8 - STRIDE results. 19 mg Fe equal to 38 mg. Specific letters with iron status info equally effective.
Slide 9 - AABB Bulletin 17-02: Time to take action!
Slide 10 - Conclusions

References Mentioned During this Episode:

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