ДОНАЦІЇ КРОВІ І МЕТАБОЛІЗМ ЗАЛІЗА
Authors: Видиборець Станіслав , Дерпак Юрій 
Published: October 2022

Blood transfusion service and its social component – donor ship must be the priority areas of the state policy because the results of its work are of paramount importance. The main task of the blood transfusion service is supply of high quality components for blood transfusion therapy. Quality of blood components is compliance of properties and specifications of the blood component supplied to the recipient with the set standards. Strict order of conformance with the approved regulations and procedures is important at all technological states and is a cornerstone of blood transfusion service products quality. All actions, planned and implemented, starting with planning donor ship and ending with the finished product manufacturing and storage conditions, are important for ensuring the quality as the final result. In spite of the lately increasing number of scientific research programs on donor blood storage, integrated solution of this problem remains a challenging open issue. We studied parameters indicative of iron metabolism in donors, and glycolytic processes in peripheral blood erythrocytes depending on history of donations, donors’ health at the time of plasma donation via automatic plasmapheresis, issues of donor ship optimization, and its medical and social aspects. Potential donors reserve decrease negatively affects the volumes of donor blood collected by the blood transfusion service of Ukraine. Reducing number of donors in contrast to the increasing need for blood components and products is a topical issue of present-day transfusion medicine because the number of donors is decreasing by 10-15% annually world wide. Exceedance of regulated number of annual donations and absence of strict control of metabolic processes in the donors can lead to abnormalities of macro- and microelement, amino acid, protein and carbohydrate metabolism and enzyme system dysfunction, which ultimately results in iron deficiency and diseases in regular blood donors. First of all, unregulated donations can disturb metabolism of iron and microelements ensuring adequate hemoglobin synthesis and erythropoiesis, functioning of metal-dependent enzyme systems and plastic processes. Pathogenic factor of iron deficiency is its negative balance caused by the discrepancy between resorption and intake, or high losses. Iron deficiency leads to erythrocyte transport function impairment (oxygen and carbon dioxide transporting), shortening of their life cycle from 120 to 56 days, and reduction of resistance to different physical and chemical factors, in particular impact on erythrocytes in donors with latent iron deficiency: freezing at ultra-cold temperatures leads to hemolysis increase to over 30% when reference rate is 2-5%. Acid resistance of erythrocytes decreases almost 2-fold (acid erythrograms demonstrate destruction of the main erythrocyte mass during the first 8 minutes instead of 15-16 minutes). In iron deficiency, erythropoiesis intensity is not accompanied by increased production of erythrocytes, but causes metabolic, functional and morphologic changes in them, which is of particular importance for blood donors because, on an average, 5% of donors stop donating for the reason of deterioration of the peripheral blood parameters. Erythrocyte destruction caused by metabolic, functional and morphologic changes in them leads to macrophage system overstraining. Besides, the above-mentioned changes in the erythrocytes of the blood donors result in donor blood quality lowering and, consequently, lower quality of blood components containing erythrocytes, which can affect the results of blood transfusion therapy and recipients’ health. Iron metabolism evaluation method used for blood donors by the Ukrainian blood transfusion service and approved legally provisions measurement of hemoglobin parameter pathophysology of which changes only at the stage of overt iron deficiency. Peripheral blood parameters abnormality detected by the establishments of the blood transfusion service in more than 5% of blood donors is a cause of denial of donations, while iron deficiency was found in 25-50% of the active donors. Study of the latent abnormalities of iron metabolism and related changes of physical properties of erythrocytes, rheological abnormalities and energy processes in erythrocytes of blood donors, as well as development of correction and prevention methods is a topical issue for the state blood transfusion service. In spite of paramount importance of the energy processes progress in erythrocytes, their impact on functional capacity of peripheral blood erythrocytes in the body of active donors, the study of this problem has just started, which calls for the development of diagnostic methods for detection of the above-mentioned changes and methods of their correction. All the above-mentioned defines the important problem of the modern transfusion medicine – determination of them pact of the changes of laboratory, morphologic, biochemical and biophysical parameters of donor erythrocytes and pathophysiologic grounding of donation safety. Solution of this problem will make available the important data on pathologic states inducing qualitative morphologic changes in erythrocytes in active donors and detection o early symptoms of such abnormalities for timely correction. However, previous research in this field did not provide clear and unambiguous answer regarding the possibility of evaluation of the latent abnormalities of laboratory, morphologic, biochemical and biophysical parameters of donor blood erythrocytes and pathophysiologic grounding of donation safety, in particular, depending on how long the person has been donating blood.