Lofti et al evaluated blood donors for iron stores followng a donation. The ratio of serum hepcidin to ferritin gives insight into iron stores of the donor. The authors are from the University Hospital Ulm and German Red Cross Blood Services Baden-Wurttemberg-Hessen in Germany.
Patient selection: recent blood donor
Facts:
(1) Each unit of whole blood donated is associated with a loss of 200 to 256 mg of iron.
(2) In a healthy donor without chronic inflammation a plasma ferritin < 15 ng/mL is associated with low body iron stores.
Parameters:
(1) serum ferritin in ng/mL on day 3 after donation
(2) serum hepcidin in pg/mL on day 3 after donation
ratio of hepcidin to ferritin =
= (serum concentration hepcidin) / (serum concentration ferritin)
Interpretation:
• A donor with a ratio < 0.3 will have regained 60% of predonation ferritin levels within 56 days (8 weeks).
• A donor with a ratio >= 0.3 will have reached less than 50% of predonation ferritin within 56 days.
• A donor with an increased ratio may benefit from oral iron supplements.
• Measurement after the fourth donation may be the most cost effective strategy for identifying a high risk group for iron deficiency in repeat donors.
