Relevance of haemoglobin monitoring in apheresis plasma donors: A retrospective cohort study in Québec, Canada.

deferral eligibility criteria frequency haemoglobin plasmapheresis safety

Journal

Vox sanguinis
ISSN: 1423-0410
Titre abrégé: Vox Sang
Pays: England
ID NLM: 0413606

Informations de publication

Date de publication:
Dec 2023
Historique:
revised: 15 08 2023
received: 02 06 2023
accepted: 17 08 2023
pubmed: 7 9 2023
medline: 7 9 2023
entrez: 6 9 2023
Statut: ppublish

Résumé

Systematically measuring pre-donation haemoglobin (Hb) levels might be overly cautious for apheresis plasma donation, since plasmapheresis entails a small loss of red blood cells. We explored the association between the frequency of apheresis plasma donation and capillary blood Hb levels. This retrospective cohort study included donors who gave apheresis plasma at least twice between 24 October 2020 and 23 October 2022 in Québec, Canada. Results were stratified by sex and analysed with linear repeated-measure mixed models with random intercepts. In total, 9535 men (mean age = 46.7 years) and 9409 women (mean age = 41.1 years) made ≥2, but no more than 16 apheresis plasma donations. Over an average of 9.2 months of observation, men maintained Hb levels well above the Hb deferral threshold, and their Hb levels decreased by only 0.17 g/dL between the 1st and 15th donation return (p < 0.0001). Over an average of 9.0 months of observation, women also maintained adequate Hb levels, and their Hb levels decreased by 0.08 g/dL between the 1st and 15th donation return. The frequency of apheresis plasma donation was not associated with clinically meaningful changes in Hb levels, neither in men nor in women. This evidence questions the relevance of systematically monitoring Hb for apheresis plasma donation, at least for donation frequencies of ≤7-8 times per year. However, an adverse impact of plasmapheresis on Hb levels cannot be ruled out for individuals donating more frequently or for longer than ~9 months.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
Systematically measuring pre-donation haemoglobin (Hb) levels might be overly cautious for apheresis plasma donation, since plasmapheresis entails a small loss of red blood cells. We explored the association between the frequency of apheresis plasma donation and capillary blood Hb levels.
MATERIALS AND METHODS METHODS
This retrospective cohort study included donors who gave apheresis plasma at least twice between 24 October 2020 and 23 October 2022 in Québec, Canada. Results were stratified by sex and analysed with linear repeated-measure mixed models with random intercepts.
RESULTS RESULTS
In total, 9535 men (mean age = 46.7 years) and 9409 women (mean age = 41.1 years) made ≥2, but no more than 16 apheresis plasma donations. Over an average of 9.2 months of observation, men maintained Hb levels well above the Hb deferral threshold, and their Hb levels decreased by only 0.17 g/dL between the 1st and 15th donation return (p < 0.0001). Over an average of 9.0 months of observation, women also maintained adequate Hb levels, and their Hb levels decreased by 0.08 g/dL between the 1st and 15th donation return.
CONCLUSION CONCLUSIONS
The frequency of apheresis plasma donation was not associated with clinically meaningful changes in Hb levels, neither in men nor in women. This evidence questions the relevance of systematically monitoring Hb for apheresis plasma donation, at least for donation frequencies of ≤7-8 times per year. However, an adverse impact of plasmapheresis on Hb levels cannot be ruled out for individuals donating more frequently or for longer than ~9 months.

Identifiants

pubmed: 37673797
doi: 10.1111/vox.13523
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1041-1045

Subventions

Organisme : Héma-Québec

Informations de copyright

© 2023 International Society of Blood Transfusion.

Références

Cloutier M-S, Apparicio P, Dubé J, Charbonneau J, Delage G. Regional variation in the modeling of donation frequency: the case of Héma-Québec, Canada. Transfusion. 2012;52:2329-2338.
Karp JK, King KE. International variation in volunteer whole blood donor eligibility criteria. Transfusion. 2010;50:507-513.
Li H, Condon F, Kessler D, Nandi V, Rebosa M, Westerman M, et al. Evidence of relative iron deficiency in platelet-and plasma-pheresis donors correlates with donation frequency. J Clin Apheresis. 2016;31:551-558.
Schreiber GB, Brinser R, Rosa-Bray M, Yu Z-F, Simon T. Frequent source plasma donors are not at risk of iron depletion: the Ferritin Levels in Plasma Donor (FLIPD) study. Transfusion. 2018;58:951-959.
Tran-Mi B, Storch H, Seidel K, Schulzki T, Haubelt H, Anders C, et al. The impact of different intensities of regular donor plasmapheresis on humoral and cellular immunity, red cell and iron metabolism, and cardiovascular risk markers. Vox Sang. 2004;86:189-197.
Héma-Québec. Who can donate? [cited 2023 Jul 20]. Available from: https://www.hema-quebec.qc.ca/sang/donneur-sang/puis-je-donner/index.en.html
Jaggernath M, Naicker R, Madurai S, Brockman MA, Ndung'u T, Gelderblom HC. Diagnostic accuracy of the HemoCue Hb 301, STAT-site MHgb and URIT-12 point-of-care hemoglobin meters in a central laboratory and a community based clinic in Durban, South Africa. PLoS One. 2016;11:e0152184.
Héma-Québec. Intervalle entre les dons [cited 2023 Apr 19]. Available from: https://www.hema-quebec.qc.ca/sang/donneur-sang/a-quoi-dois-je-mattendre/intervalle-entre-les-dons.fr.html
Canadian Blood Services. Am I eligible to donate blood? [cited 2023 Apr 19]. Available from: https://www.blood.ca/en/blood/am-i-eligible-donate-blood#:~:text=In%20good%20general%20health,17%20and%2023%20years%20old
Pant S, Bagha R, McGill S. International plasma collection practices: project report. Can J Health Technol. 2021;1. https://doi.org/10.51731/cjht.2021.213
Patel AJ, Wesley R, Leitman SF, Bryant BJ. Capillary versus venous haemoglobin determination in the assessment of healthy blood donors. Vox Sang. 2013;104:317-323.

Auteurs

Antoine Lewin (A)

Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada.

Marc Germain (M)

Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada.
Medical Affairs and Innovation, Héma-Québec, Québec, Québec, Canada.

Christian Renaud (C)

Medical Affairs and Innovation, Héma-Québec, Montréal, Québec, Canada.

Nancy Robitaille (N)

Transfusion Medicine, Héma-Québec, Montréal, Québec, Canada.

Catherine Latour (C)

Transfusion Medicine, Héma-Québec, Montréal, Québec, Canada.

Classifications MeSH