Systematic reviews regarding iron and iron supplementation in blood donors

  • Graham Alan Smith

Student thesis: Doctoral Thesis


Background: Blood donors are required to exceed a minimum haemoglobin level before they donate; those who fail are temporarily deferred from blood donation. In this way, donor health, and that of the recipient (patient), is assured and a drain on blood collection resource is avoided. Knowing what factors contribute to donors failing to reach these levels and whether provision of iron supplements decrease deferral rates would prove beneficial to blood collection agencies.

Methods: Two systematic reviews of available literature were conducted after searching on-line databases. The first looked at observational studies of demographic data, donation history and haematological and biological factors that might be associated with deferral from blood donation. The second review studied only randomised controlled trials and was carried out using the protocols and facilities of the Cochrane Collaboration to assess the efficacy and safety of iron supplementation to reduce iron deficiency and/or anaemia.

Results: Fifty-five studies met the inclusion criteria for the first review, thirty studies were included in the second. Key findings are:
1. Females show a significantly greater risk (11-fold) of donor low haemoglobin deferral as compared to males.
2. Higher deferral rates were also associated with increasing age, higher ambient temperature, lower body mass, shorter donation interval or being of certain ethnicity.
3. Donor deferral is reduced by taking iron supplements but the evidence is moderate.
4. Those taking iron supplementation are subject to more frequent adverse events.

Conclusions: These peer-reviewed and published works help define criteria that should be considered in large scale studies of donor deferral, especially any which attempt to address failure to meet low haemoglobin thresholds. Additionally, although donors may benefit from iron supplementation, the risk of side effects means it is unlikely to be a universal treatment. Together these reviews may help determine suitable donation intervals which decrease risk of donor iron-deficiency.
Date of AwardSept 2014
Original languageEnglish
SupervisorSally Anne Kilburn (Supervisor) & Amy Drahota-Towns (Supervisor)

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