Hereditary hemochromatosis (HH) is a genetic disorder of iron metabolism that may lead to iron overload. Clinical penetrance is low, however those afflicted may develop cirrhosis, hepatocellular carcinoma, diabetes mellitus, and cardiomyopathy. Treatment of HH involves regular phlebotomy to reduce the systemic iron burden. In many countries—including the United States—numerous blood centers do not accept donated blood obtained from HH patients during therapeutic phlebotomy and there are inconsistent positions regarding this globally. This refusal of blood is borne out of a few concerns. First, there is a theoretical increase in the infectious risk of these blood products, particularly by siderophilic organisms such as Yersinia enterocolitica. Second, given the increased incidence of hepatitis C infection from nonvoluntary donors in the 1970s, there is a concern that blood units from HH donors may harbor additional risk given the nonvoluntary nature of their presentation. In this review, we examine the existing biological and clinical data concerning infectious risk and summarize clinical experience from centers allowing HH donors, and demonstrate that blood from HH patients is safe and should be allowed into the donor pool. We conclude that there is no convincing evidence to exclude this population from serving as blood donors. (Hepatology 2018;67:1150–1157)

中文翻译：

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重新评估利用血色素沉着病患者献血的安全问题


遗传性血色素沉着症（HH）是一种铁代谢遗传性疾病，可能导致铁超载。临床外显率较低，但患者可能会发展为肝硬化、肝细胞癌、糖尿病和心肌病。 HH 的治疗包括定期放血以减少全身铁负荷。在许多国家（包括美国），许多血液中心不接受 HH 患者在治疗性放血期间捐献的血液，并且全球对此的立场不一致。拒绝输血是出于一些担忧。首先，理论上这些血液制品的感染风险会增加，特别是小肠结肠炎耶尔森氏菌等嗜铁微生物的感染风险。其次，考虑到 20 世纪 70 年代非自愿捐献者丙型肝炎感染发病率的增加，人们担心，由于 HH 捐献者的血液单位表现的非自愿性质，可能会带来额外的风险。在本次综述中，我们检查了有关感染风险的现有生物学和临床数据，并总结了允许 HH 献血者的中心的临床经验，并证明来自 HH 患者的血液是安全的，应允许进入献血池。我们的结论是，没有令人信服的证据表明该人群不能成为献血者。 （肝病学 2018；67：1150–1157）