{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:04:30Z","timestamp":1789657470450,"version":"4.0.1"},"reference-count":12,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low hemoglobin (Hb) is the leading cause of blood donor deferral yet mean Hb values are seldom examined as sentinel indicators of changes in donor recruitment, assessment, or testing. Case in point, following unexplained improvement in these parameters, U.S. blood centers observed a sharp rise in low\u2010Hb deferrals after the 2024 introduction of a new international calibrator for some fingerstick hemoglobinometers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 15\u2009years (2010\u20132024) of allogeneic donor data from a national blood center. Mean donor Hb and low\u2010Hb deferral rates were trended overall and by sex, cognizant of temporal practices affecting values like a ferritin testing program, the 2016 male Hb cutoff adjustment, and acceptance of allogeneic donors with testosterone\u2010associated polycythemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among &gt;11 million presentations (49.8% female), mean Hb values rose progressively from 2016 through 2023, correlating with a suspected gradual positive bias from a degrading hemoglobinometry standard. Female low\u2010Hb deferrals declined from 12.2% (2016) to 7.7% (2023) before rebounding to 2016 levels in 2024 following recalibration. Male mean Hb trends were additionally influenced by increasing testosterone use in the donor base and the higher 13.0\u2009g\/dL Hb cutoff. Ferritin\u2010based deferral programs temporarily raised mean Hb and reduced low\u2010Hb deferrals, which reversed when suspended.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Hemoglobinometer calibration drift, a ferritin testing policy, and donor testosterone use together shaped long\u2010term donor Hb trends. Surveillance of mean donor Hb should be treated as a sentinel metric, and unexpected declines and increases in related deferral rates warrant the same scrutiny to protect both donors and blood availability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70116","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:34:04Z","timestamp":1770287644000},"page":"720-727","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sentinel trends in donor hemoglobin values and low\u2010hemoglobin deferrals in a large\n                    <scp>US<\/scp>\n                    blood center"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-9905","authenticated-orcid":false,"given":"Ruchika","family":"Goel","sequence":"first","affiliation":[{"name":"Corporate Medical Affairs  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3562-5556","authenticated-orcid":false,"given":"Marjorie","family":"Bravo","sequence":"additional","affiliation":[{"name":"Corporate Medical Affairs  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Corporate Medical Affairs  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8754-047X","authenticated-orcid":false,"given":"Ralph","family":"Vassallo","sequence":"additional","affiliation":[{"name":"Corporate Medical Affairs  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2019.10.002"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14825"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.14254"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-553X.2009.01196.x"},{"key":"e_1_2_9_6_1","volume-title":"Technical letter #32: new ICSH reference material for standardization of hemoglobin measurements","author":"Clinical & Scientific Affairs, Hemocue AB","year":"2024"},{"key":"e_1_2_9_7_1","volume-title":"Requirements for blood and blood components intended for transfusion or for further manufacturing use. Federal Register","author":"US Food and Drug Administration","year":"2015"},{"issue":"3","key":"e_1_2_9_8_1","first-page":"20A","article-title":"Ferritin testing of adult donors with a prior low hemoglobin (Hb) deferral","volume":"64","author":"Vassallo R","year":"2024","journal-title":"Transfusion"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1530\/EC-24-0283"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0309160"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2022.11.001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17085"},{"issue":"2","key":"e_1_2_9_13_1","first-page":"34A","article-title":"Factors associated with absent iron stores (AIS) in male and female donors tested for ferritin (abstract)","volume":"53","author":"Custer B","year":"2013","journal-title":"Transfusion"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70116","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70116","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:17:10Z","timestamp":1789654630000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/trf.70116"],"URL":"https:\/\/doi.org\/10.1111\/trf.70116","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,5]]},"assertion":[{"value":"2025-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}