A ferritin prediction model to determine individual blood donation frequencies

BACKGROUND: Ferritin-guided donation intervals are effective in reducing iron deficiency and low hemoglobin rates. However, many donors still present with low ferritin levels after multiple donations, which results in less donor availability. Model predictions of ferritin levels can help in setting donation frequencies that, proactively, keep ferritin levels above thresholds and donors available for donation. STUDY DESIGN AND METHODS: We created a physiology informed model to predict ferritin levels in whole blood donors. This model takes as input: baseline ferritin and hemoglobin, donation intervals, donated volume and height and weight of a donor. We used data from several studies to tune our model and validated ferritin predictions on routinely collected donation data from new donors in the Netherlands that started in 2021. RESULTS: The model predicted ferritin levels after five donations accurately, with 71% being within the range determined from the measurement uncertainty. Average ferritin predictions show a slight underestimation and accuracy varied by sex and age. We created tables of optimal donation frequencies given baseline ferritin levels and weight, which were shown to have the most influence on predicted ferritin levels after multiple whole-blood donations. DISCUSSION: Personalized donation intervals offer a promising approach to shift from a reactive management of iron deficiency to proactively protect donor health and preserve long-term donor availability. The healthy donor effect could explain the slight underestimation of predictions on average, and model accuracy may be further improved by, for instance, adding information on menstrual blood loss to account for sex- and age-related differences.