title: Screening for hemosiderosis in patients receiving multiple red blood cell transfusions.
abstract: BACKGROUND
  The dramatic impact of hemosiderosis on survival in chronically transfused patients with hereditary anemia is well known. We evaluated whether patients receiving multiple red blood cell (RBC) transfusions are adequately screened for hemosiderosis.
  
  
  METHODS
  We retrospectively assessed hemosiderosis screening and prevalence in adult patients that received over twenty RBC units in the University Medical Centre Utrecht from 2010 till 2015. Hemosiderosis was defined as ferritin ≥1000 μg/L. Adequate screening for chronically transfused patients was defined as any ferritin determined up to 3 months before or any moment after the last transfusion, while for patients that received all transfusions within 3 months (bulk transfusion), ferritin had to be determined after at least twenty transfusions.
  
  
  RESULTS
  Of 471 patients, only 38.6% was adequately screened and hemosiderosis prevalence was 46.7%. Hemosiderosis prevalence was 47% in the chronic transfusion group and 12% in the bulk transfusion group. In patients transfused because of hematological malignancy or cardiothoracic surgery, respectively, 74% and 31% were adequately screened and hemosiderosis prevalence was 53% and 13%, respectively.
  
  
  CONCLUSIONS
  Hemosiderosis screening in our routine practice is suboptimal. Hemosiderosis is not an exclusive complication of multiple transfusions in the hematology ward. We recommend screening for hemosiderosis in all patients receiving multiple transfusions.
authors.affiliation: Van Creveldkliniek, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Adriaan D
authors.initials: AD
authors.lastname: de Jongh
authors.affiliation: Van Creveldkliniek, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Eduard J
authors.initials: EJ
authors.lastname: van Beers
authors.affiliation: Department of Clinical Chemistry and Haematology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Karen M K
authors.initials: KMK
authors.lastname: de Vooght
authors.affiliation: Van Creveldkliniek, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Roger E G
authors.initials: REG
authors.lastname: Schutgens
mesh_terms: D000368:Aged; D001803:Blood Transfusion / Q000379:methods; D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005293:Ferritins / Q000097:blood; D006486:Hemosiderosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D005293:Ferritins
keywords: blood transfusion; ferritin; hemosiderosis; screening