Comparative Analysis of Red Cell Parameters of First-time and Repeat Blood Donors: A Descriptive Study

Introduction: Blood transfusion services form an essential component of any healthcare system and it is imperative to provide adequate and safe blood for management of patients. Voluntary blood donors form the backbone of this service. However, regular donation by such voluntary donors may cause significant depletion of iron stores in the body. This has the potential to adversely affect the donor’s health, and also to lower the quality of blood being collected subsequently. The temporary deferral of such donors also causes reluctance to return for future blood donations, leading to decrease in size of the donor pool. The prompt detection of subclinical iron deficiency in voluntary blood donors is the need of the hour.

Aim: To compare and analyse the difference in red cell parameters of first-time and repeat blood donors.

Materials and Methods: A descriptive study was conducted by the Department of Blood Bank and Pathology at Rajarshi Dashrath Autonomous State Medical College, Ayodhya, Uttar Pradesh, India, from July 2021 to December 2022. After prospective donors were assessed for suitability of blood donation, written informed consent was obtained, and 5 mL venous blood was collected into an Ethylenediaminetetraacetic Acid (EDTA)-anticoagulated vial via the antecubital fossa. Complete blood count was performed within one hour of collection using an automated haematology analyser. The parameters analysed in the study were Red Blood Cell (RBC) count, haemoglobin, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), and Red cell Distribution Width (RDW). The generated data was compiled and statistical analysis, with Kruskal-Wallis test (at a p-value of 0.05) and post-hoc Dunn test was performed to determine the significant differences, if any.

Results: The study included 455 participants, out of which 210 were repeat blood donors. The significant differences for MCV, MCH and RDW between groups defined by number of donations (p-value <0.001) was observed. The difference was most significant between the donors having five or more donations compared to donors having no previous donations. No significant differences were observed for other parameters, with p-values for RBC count, haemoglobin, and MCHC being 0.3, 0.07, and 0.09, respectively.

Conclusion: Repeat blood donors having low MCV and MCH along with high RDW, with haemoglobin values within normal range, are most susceptible to having subclinical iron deficiency, which needs to be identified and managed pre-emptively, before development of Iron Deficiency Anaemia (IDA). This is necessary in order to retain regular and repeat voluntary blood donors, and also to ensure adequate quality of collected blood.