Lifeblood haemoglobin screening
Lifeblood routinely screens each donor’s haemoglobin (Hb) level prior to every donation. In most cases this is performed on a capillary fingerprick sample on our point of care device. In some centres it is performed on a venous sample. If the capillary result is outside our acceptable range, we collect a venous sample and test on our point of care device.
If the Hb is between 115-119g/L for female donors and 125-129g/L for male donors we also collect a ferritin sample. Donors are notified of their results within approximately 2 weeks.
If the Hb is below 115g/L for female donors and 125g/L male donors we refer them to their general practitioner. The urgency of the appointment is guided by their result and a discussion with one of our Lifeblood Medical Officers. We do not conduct any further tests.
Lifeblood acceptable haemoglobin ranges
Assessment of iron status in blood donors
Blood donation removes red cells and therefore iron. Lifeblood and international research has shown that donors most at risk of iron deficiency are younger donors, female donors and those who undergo frequent whole blood donations. The iron loss associated with whole blood donation may represent up to 75% of a premenopausal woman’s iron stores.
Depending on the frequency of plasma and or platelet donations, these donations may also contribute to low iron stores. Poor oral iron intake or ongoing blood loss (e.g. menstruation) may contribute to inadequate iron replacement and iron deficiency.
Haemoglobin is known to be a poor predictor of iron deficiency in blood donors. Donors may therefore have an acceptable haemoglobin but have low iron stores.
Lifeblood has recently started routine ferritin testing in donors. The initiative commenced in August 2023 and is initially targeting new whole blood donors. The strategy will expand to returning donors in 2024.
Ferritin testing is also performed for a limited number of other indications including:
- significant drop in haemoglobin between successive donations
- a haemoglobin in the lower end of the acceptable range
Lifeblood reference intervals for ferritin are:
Male 30–500 ug/L
Female 15–400 ug/L
All donors will be informed of their ferritin results within two weeks. Those with results outside of our reference range will be advised to see their doctor. Eligibility to donate will be guided by the ferritin and haemoglobin result.
|Minimum donation interval^||12 weeks||2 weeks||2 weeks|
|Volume collected mL||500||460-800||650|
|Iron loss (mg)*||250||10||48|
^The minimum donation interval applies to donations of the same type. There are specific intervals between different donation types.
*For apheresis collections iron loss is associated with samples and inline tubing loss
Reducing the risk of iron deficiency in blood donors
To reduce the risk of iron deficiency in blood donors, consider:
- Donating plasma or platelets rather than whole blood.
- Reduced frequency of whole blood donation.
- Iron supplementation:
- As women between the ages of 18-45 years are more susceptible to low iron, Lifeblood is recommending these donors take a short course of oral iron following each whole blood donation. Find out more about our recommendation here.
Other donors are advised to discuss the use of iron supplements with their doctor.
Donors with iron deficiency, with or without anaemia, should be medically assessed.
Assessment of blood donors with iron deficiency anaemia in the community
The assessment of blood donors with iron deficiency anaemia is not significantly different to that of the general population. It will depend on their age and gender, the likely contribution of blood donation to the iron deficiency, other potential causes, and the likelihood of underlying pathology. The following should be taken into consideration:
- A single blood donation in an at-risk person can result in iron deficiency anaemia, however many donors are able to successfully donate on a regular basis without developing anaemia.
- Causes of iron deficiency are often multifactorial.
- The Gastroenterological Society of Australia (GESA) cautions that even when an obvious cause of iron deficiency exists, the possibility of serious underlying cause must also be considered.
- Treatment of the iron deficiency and determination of the underlying cause should occur concurrently.