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Blood of uncomplicated hemochromatosis patients safe for transfusion

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Blood from patients with uncomplicated hemochromatosis is safe and effective for transfusion, researchers from the Belgian Red Cross report in the June 1st online Journal of Hepatology.

“Physicians should encourage their patients, once they have normalized iron levels and no further complications, to maintain their iron level by donating blood,” Dr. Emmy De Buck from Belgian Red Cross-Flanders, Mechelen, Belgium told Reuters Health in an email. “In this way their blood is put to good use instead of being destroyed, and the patients/donors will have a heightened sense of contribution and thus a higher satisfaction.”

Dr. De Buck and colleagues undertook a systemic review of the literature to address the question of whether blood of uncomplicated hemochromatosis patients is safe and effective for blood transfusion. Six observational studies met their inclusion criteria.

Overall, the strength of the body of evidence was low to very low.

In the only study that examined efficacy parameters, there was no evidence that blood derived from hemochromatosis patients does not comply with quality requirements from a hemato-physiological point of view.

In 2 studies that examined the safety of the blood, there were no statistically significant differences between hemochromatosis donors and regular donors in positive screening test results for viruses.

Two in vitro studies, however, suggested that blood obtained from iron-overloaded patients would be more susceptible for bacterial growth.

“There is no evidence for more bacterial growth in the blood of patients with uncomplicated hemochromatosis with normalized iron levels,” Dr. De Buck said, “so until further evidence becomes available about the blood of iron-overloaded patients we only support the use of patients with normalized iron levels.”

“Today, the policy with regards to accepting these donors differs greatly between countries,” Dr. De Buck said. “We would like to call for harmonization of the donor policy for hemochromatosis patients, a policy that is based on the best available evidence and not on assumptions/traditions.”

“Based on the available scientific evidence there is no reason to exclude hemochromatosis patients without organ damage or other complications of iron overload, once iron levels are normalized,” Dr. De Buck concluded. “These are patients who undergo maintenance therapy, giving blood several times a year to maintain their iron level. Because there is concern that these donations are not voluntary, and donors may not answer truthfully on the questionnaire, the donor medical questionnaire should be used rigorously while guaranteeing phlebotomy.”

SOURCE:

Is blood of uncomplicated hemochromatosis patients safe and effective for blood transfusion? A systematic review

J Hepatol 1 June 2012.