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Thomas S. Kickler, MD; Jerry L. Spivak, MD

JAMA. 1988;260(1):65-67.

Abstract
The effect of repeated phlebotomy on serum immunoreactive erythropoietin levels was studied prospectively in 69 autologous blood donors. At the time of the initial phlebotomy, 11 men (33%) and two women (6%) were anemic; during the course of blood donations, anemia (defined as a hematocrit <0.41 for men and <0.36 for women) developed in an additional 17 men (71%) and 14 women (45%). Although there was an increase in the level of serum immunoreactive erythropoietin with successive phlebotomies, the increase was not substantially out of the normal range. The lack of an erythropoietic response to repeated phlebotomies in association with the small increment in the serum erythropoietin level was not due to iron deficiency, since the level of red-cell free protoporphyrin did not increase in these patients. We conclude that within the hematocrit range permissible for autologous blood donation, the degree of anemia experienced is insufficient to initiate an adequate increase in erythropoietin production; as a consequence, mild anemia develops in a majority of donors, and the volume of blood donated is inadequate to meet their operative needs.

(JAMA 1988;260:65-67)

Author Affiliations
From the Division of Laboratory Medicine, Department of Pathology (Dr Kickler), and the Division of Hematology, Department of Medicine (Dr Spivak), The Johns Hopkins University School of Medicine, Baltimore.

Footnotes
Reprint requests to Blalock 1033, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21205 (Dr Spivak).

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