title: The impact of noninvasive, capillary, and venous hemoglobin screening on donor deferrals and the hemoglobin content of red blood cells concentrates: a prospective study.
abstract: BACKGROUND
  Hemoglobin (Hb) is screened before whole blood donation to protect donors from anemia. Recently, noninvasive methods have become available for Hb screening in blood donors. We compared a noninvasive, a capillary, and a venous method for Hb screening of blood donors.
  
  
  METHODS
  Consecutive donors were prospectively screened using a noninvasive (Masimo Pronto-7), a capillary (HemoCue Hb 301), and a venipuncture-based method as gold standard (Siemens Advia 2120i) for Hb determination. All measurements were performed in parallel and in duplicate. A cutoff Hb value of 125 g/L (females) and 135 g/L (males) was used for donor acceptance.
  
  
  RESULTS
  A total of 553 donors were analyzed; in 38 donors (7%) the noninvasive Hb method was not applicable due to technical reasons. The noninvasive test underestimated (mean bias, -5.9 g/L; 95% limits of agreement, -25.74, 13.88) and the capillary test overestimated Hb values (mean bias, 4.3 g/L; 95% limits of agreement, -8.13, 16.71). Coefficients of variation of duplicate measurements were 1.05 (venous), 2.73 (noninvasive), and 3.23 (capillary). The noninvasive test revealed false low Hb values in 21.2% and the capillary test revealed false high Hb values in 9% of donors compared to the venous method. The negative predictive value of the noninvasive test was 94.3%.
  
  
  CONCLUSIONS
  The noninvasive Hb measurement is a reasonable first-line approach for predonation Hb screening of blood donors but a second method should be available to retest those not testable with the noninvasive device or with Hb values below the cutoffs.
authors.affiliation: Institute for Immunology and Transfusion Medicine.
authors.forename: Ariane
authors.initials: A
authors.lastname: Sümnig
authors.affiliation: Clinic for Internal Medicine A.
authors.forename: Gregor
authors.initials: G
authors.lastname: Hron
authors.affiliation: Institute for Immunology and Transfusion Medicine.
authors.forename: Antje
authors.initials: A
authors.lastname: Westphal
authors.affiliation: Institute for Clinical Chemistry and Laboratory Medicine.
authors.forename: Astrid
authors.initials: A
authors.lastname: Petersmann
authors.affiliation: Institute for Community Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kohlmann
authors.affiliation: Institute for Immunology and Transfusion Medicine.
authors.forename: Andreas
authors.initials: A
authors.lastname: Greinacher
authors.affiliation: Institute for Immunology and Transfusion Medicine.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thiele
mesh_terms: D000328:Adult; D001782:Blood Donors; D002196:Capillaries; D004912:Erythrocytes / Q000737:chemistry*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins