P112 Ironing out the issues: enhancing blood donation through haemochromatosis management

<h3></h3> Genetic haemochromatosis is a common genetic condition in Western Europe, Ireland having the highest rates in the world. Characterised by a genetic predisposition to iron overload, the mainstay of treatment is venesection to remove excess iron. Untreated, there is the potential for end organ damage, including the liver, with long-term risks of cirrhosis and hepatocellular carcinoma. Initial phase treatment involves fortnightly venesection until target ferritin is reached. Patients then move into the maintenance phase, with most patients requiring venesection on a 3–4 monthly basis. Many patients with haemochromatosis are also eligible to be blood donors. Until recently, most Belfast Trust patients requiring venesection attended the Programmed Treatment Unit (PTU) of the Royal Victoria Hospital (RVH). Unfortunately, this blood cannot be utilised for altruistic donation, leading to approximately 100 units of blood being discarded each week, at a time when it was necessary to import blood for use in Northern Ireland. In excess of 500 patients with haemochromatosis undergo regular venesection in PTU, leading the unit to reach full capacity, resulting in a delay in treatment of newly diagnosed patients, potentially leading to increased clinical risk. Despite the close proximity of the headquarters for the Northern Ireland Blood Transfusion Service (NIBTS) to RVH, before April 2023, there was no established link between these 2 services. Since then, in an effort to address the dual issues of an increasing waiting list for venesection and the availability of blood products, the RVH Liver unit and NIBTS have worked collaboratively to identify patients both, who wish to undertake venesections through NIBTS and are suitable blood donors, establishing robust governance processes around blood donation and monitoring of ferritin and haemoglobin levels. This led to the appointment of a haemochromatosis specialist nurse in November 2024. During the first 6 months of this new service, 67 patients were referred to NIBTS as blood donors – 28 maintenance phase venesection patients previously attending PTU, and 39 initial phase patients from the waiting list to start treatment. To date, a further 99 patients have been identified as potentially suitable donors. This number is increasing with ongoing review of established patients, alongside new referrals into the service. It is anticipated that increased utilisation of NIBTS will both improve access to venesection for haemochromatosis patients and increase the pool of blood donors. By transforming therapeutic waste into lifesaving donations, Northern Ireland turned a genetic vulnerability into a cornerstone of blood resilience.