OBJECTIVES:

Implementing a ferritin testing policy for whole-blood (WB) donors may prevent from iron deficiency (ID, ferritin <26ng/ml) and anemia, but may induce a loss of donation. As part of a national prevention plan in France, we aimed to estimate its impact on ID, anemias and WB donations among donors at high-risk of ID.

METHODS:

A micro-simulation model was developed to evaluate different scenarios compared to the current situation without ferritin testing as a reference scenario. A minimum scenario with a six-month deferral for donors with absent iron store (AIS) with ferritinemia <15ng/ml, a main scenario with additional spaced invitations for donors with ferritinemia 15-<26ng/ml, and a supplementation scenario with additional iron supplementation for 50% of the donors with AIS were simulated.

RESULTS:

In the main scenario, 53,000 WB donations per year were estimated to be lost after one year (-8%), reduced to 28,000 (-4.7%) after 5 years. IDs and anemias were reduced by 13.6% and 29.3%, respectively, after one year. The supplementation scenario increased the number of prevented IDs and anemias to 24.1% and 35.4% respectively after one year, and reduced the number of anemias at 5 years by one half. The latest scenario was also the one with the least impact on the number of donations (-3.2% after 5 years).

CONCLUSIONS:

A ferritin testing policy resulting in spaced donations for donors with ID is effective to reduce IDs and anemias, but has a significant impact on the number of donations that may be a challenge for self-sufficiency.