Assessment of Serum Ferritin and Haemoglobin Concentration in Multi-Transfused Patients in Owo, South Western Nigeria

Abstract

Introduction: Blood transfusion is a therapeutic, life-saving intervention. It has been widely used and overused in medical practice since the early 20th century to treat anaemia and haemorrhage. Blood transfusion may cause some adverse effects in serum ferritin levels and haemoglobin concentrations, as may be occasioned by overload. This study was carried out to determine the effects of multiple transfusions on patients' iron storage and haemoglobin concentration in Owo, southwest Nigeria.

Materials and Methods: Ethical approval was obtained as required. A total of 87 participants were recruited for this study, comprising 67 recipients of multiple transfusions and 20 subjects who had never received a blood transfusion. Haemoglobin was estimated using a standard ELISA technique, and serum ferritin was estimated using a colourimetric method. Data were analysed with SPSS version 25.0. Values were considered significantly different at P < 0.05.  

Results: The mean ± standard error of the mean (SEM) of haemoglobin concentration revealed a significant decrease when multiple transfused subjects with 5 pints and above (12.57± 1.17) were compared to recipients of 2-4 pints (12.16± 1.25) with p=0.001. The mean ± standard error of the mean (SEM) of serum ferritin level was significantly elevated in multiple transfused subjects with 5 units and above (308.38±114.09); as compared with recipients of 2-4 units (279.95± 95.36) and those never transfused (100.92±20.29) with a p-value of 0.001. Gender has no significant effect on serum ferritin levels (p=0.227). The mean standard error of the mean of haemoglobin concentration revealed a significant difference in males (13.19±1.25) as compared to females (12.19±1.55) with p =0.001.

Conclusion: The significantly elevated serum ferritin in multi-transfused patients suggests iron overload, which is reflected in the haemoglobin concentration, which also increased with the increase in the number of units transfused. Thus, assessment of serum ferritin and haemoglobin concentration should be considered as post-transfusion monitors in anaemic patients.