Hemoglobin screening in prospective blood donors: Comparison of different blood samples and different quantitative methods

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Abstract

Portable photometers are increasingly used for hemoglobin screening in blood centers.

In a total of 500 unselected prospective blood donors, venous hemoglobin concentrations were measured using a hematology analyzer, and fingerstick hemoglobin concentrations were measured on both a HemoCue B and a Biotest hemoglobin photometer. In 100 of the donors, earstick hemoglobin levels were also measured on the HemoCue system. The mean hemoglobin levels in the fingerstick samples were slightly higher than those in the venous samples. The deviation exceeded the limit of ±10 g l−1 in 9% of samples tested by HemoCue and in 20% of those investigated by Biotest. The use of earstick samples led to considerable overestimation of the actual hemoglobin concentration.

Introduction

Hemoglobin determination before blood donation is obligatory in most countries, and a hemoglobin level below 125 g l−1 for females and 135 g l−1 for males is widely accepted as the donation cutoff. However, hemoglobin screening in donors is not standardized. The reference method for determination of hemoglobin is the cyanhemoglobin method provided by automatic hematology analyzers. However, this technique requires a venipuncture before blood donation, and is not suitable in mobile blood donation settings. The semiquantitative gravimetric copper sulfate method is very easy and inexpensive, but does not provide an acceptable degree of accuracy [1], [2], [3]. The spun microhematocrit method is often applied to retest donors who failed the copper sulfate screening [4], [5]. This technique is relatively time-consuming and impracticable. Therefore, many centers prefer portable photometer devices with special microcuvettes containing all necessary reagents in dry form. The precision of these devices seems to be satisfactory for venous samples, but not for capillary samples [2], [6], [7].

Here, we present the results of hemoglobin determination using different types of blood samples and different methods of testing.

Section snippets

Materials and methods

A total of 250 female and 250 male unselected prospective blood donors (age 18–67 years) were included in the study, which was approved by the Ethics Committee of the Charité—University Medicine Berlin, Germany. Informed consent was obtained from all volunteers.

In capillary blood samples, hemoglobin was measured by the acid methemoglobin method using a HemoCue B photometer (HemoCue, Großostheim, Germany), and a Biotest photometer (Biotest Medizintechnik GmbH, Alzenau, Germany). Venous

Results

The venous hemoglobin levels ranged from 94 to 176 g l−1. A total of 27% (68/250) of the females and 11% (28/250) of the males tested had unacceptable hemoglobin levels (<125 g l−1 for females and <135 g l−1 for males according to the German guidelines for blood donation).

As expected, the venous and fingerstick hemoglobin results correlated well (Pearson’s correlation coefficient r = 0.93 for HemoCue and r = 0.92 for Biotest). The fingerstick hemoglobin values tended to be higher than the venous

Discussion

These high rates of erroneous acceptance and deferral of blood donors due to inaccurate hemoglobin measurement underline the need to reduce errors in hemoglobin screening for prospective blood donors. In the present study, we compared the results of hemoglobin measurements obtained using different types of blood samples and different test systems. The mean deviation of fingerstick hemoglobin measurements obtained using two different portable photometers compared to venous hemoglobin

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