Iron deficiency in whole blood donors.

Each year, 5 million regular donors meet almost half the transfusion needs of the United States by voluntarily giving their blood. In this issue of Transfusion, we learn how well the needs of these committed donors are being met from an analysis of enrollment data from the Retrovirus Epidemiology Donor Study-II (REDS-II) Donor Iron Status Evaluation (RISE) study of the National Heart, Lung, and Blood Institute.1 The RISE study is the largest and most comprehensive study yet conducted of iron deficiency in blood donors, with an enrollment of 2,425 women and men. The results are alarming. Among frequent donors, two-thirds (66%) of the women and almost half (49%) of the men were iron deficient.1 The true prevalence of iron deficiency among regular donors is surely higher; the RISE study enrolled only frequent donors who had been accepted for donation, excluding those deferred for a low hemoglobin concentration. Moreover, the enrolled, iron-deficient donors then each donated a unit of whole blood, further depleting their body iron by an additional 200 to 250 mg. Neither these loyal donors nor the national blood supply are well served by the collection practices and regulatory framework that have produced widespread iron deficiency among those who regularly give their blood.