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Insulin resistance, overweight, and obesity in apheresis donors: A call to reevaluate their eligibility—A prospective cohort study

Year: 2025

Type: article

Abstract: BACKGROUND: Apheresis procedures and the infusion of acid-citrate-dextrose induce metabolic alterations that may influence glucose metabolism. Although insulin resistance (IR), overweight, and obesity are not exclusion criteria for blood donation, their impact during apheresis procedure and on post-donation metabolic responses remains insufficiently characterized. STUDY DESIGN AND METHODS: A prospective cohort study was conducted with plateletpheresis donors approved by the IRB. Blood samples were collected at three time points: pre-donation, immediately post-donation, and 90 min post-meal for biochemical and hormonal profiling. Donors consumed a supervised post-donation meal (415 kcal) within 30 min. IR was assessed using the Homeostasis Model Assessment (HOMA-IR), while overweight and obesity were evaluated through body mass index (BMI). Multiple linear regression models were adjusted based on directed acyclic graphs. RESULTS: A total of 108 plateletpheresis donors were included. Post-donation, all donors exhibited significant increases in glucose, insulin, and C-peptide levels, with changes up to threefold higher in donors with IR, overweight, or obesity (p < .001). Mineral chelation occurred universally, independent of HOMA-IR or BMI status. Donors without IR or those with normal weight achieved baseline glucose levels following the post-donation meal. Linear regression analysis revealed that post-donation glucose changes were comparable to those induced by the 415-kcal meal. CONCLUSION: Donors with IR, overweight, or obesity are at risk of experiencing disruptions in glucose and insulin levels, for which recovery times remain unknown. Therefore, they require assessment and education regarding potential metabolic alterations associated with the apheresis procedure.

Source: Transfusion

DOI: 10.1111/trf.18262