Update notice: Chapters 3, 4, 5, 6 have been redrafted. Please refer to Change Notification 12 - 2010.
3.9 Genetically determined conditions
An increasing number of genetically determined conditions that potentially affect donor health are being identified, and some donors have had specific tests which confirm that they possess variant genes. These include not only the haemoglobinopathies and thalassaemias, but also more recently discovered conditions such as the thrombophilias (e.g. factor V Leiden). Mere possession of such genetic variants does not debar from donation if the donor is otherwise healthy and fulfils all other selection criteria.
This is a special case. Blood from individuals with genetic haemochromatosis (GH) who have no symptoms arising from their GH is intrinsically safe for transfusion. However, before patients with GH who require continued venesection for the maintenance of their health are accepted as blood donors, the consultant with responsibility for donors must ensure that the following criteria are met:
the selection criteria/methods for all donors with GH preserve the principles of altruism
blood donated for therapeutic use by any donor known to have GH meets all other criteria (except donation frequency) in the JPAC Donor Selection Guidelines.(1) If it is clinically appropriate for individuals to donate more frequently than the minimum donation interval, specific permission must be obtained from the designated medical officer
the donor is under the continuing care of a physician who is able to offer alternative venesection facilities whenever, for any reason, the donor does not meet all other criteria in the JPAC Donor Selection Guidelines.(1)
3.10 Donors on treatment with medications (drugs)
Donor deferral for most drugs is based on the underlying illness suffered by the donor rather than for the properties of the drug itself, e.g. cardiovascular disease, diabetes, anaemia and malignancies. Since, in general, traces of drugs in blood and blood components are believed to be harmless to patients, many people taking medications – even when prescribed – are acceptable as blood donors so long as the reason for which the medication is taken is acceptable.
A pragmatic view should be taken of treatment of infections with antimicrobials. Providing the donor is in good health, deferral is limited to two weeks from full recovery and one week after cessation of antimicrobial therapy, whichever is the longer. This is based on what may be regarded as a reasonable recovery period for the infection and is not related to the antimicrobial therapy itself.
Donors taking drugs which are proven or potential teratogens (e.g. vitamin A derivatives) or who are taking drugs that accumulate in tissues over long periods, should not be accepted for blood donation. Some such drugs may be taken to prevent diseases to which the donor – though currently healthy – is prone. A decision to accept should be taken after considering the pharmacodynamics of the specific drug, and its mode of action. The period of deferral after finishing a course of treatment is set out in the JPAC Donor Selection Guidelines.(1)
The current JPAC Donor Selection Guidelines (1) must be referred to for all donors who have had immunizations.
Sporadic self-medication with some drugs (e.g. vitamins, aspirin, sleeping tablets) need not prevent a donation being accepted, providing the donor is in good health.
If the donor has taken drugs affecting platelet function (e.g. aspirin) within either the last two or five days the donation shall not be used for preparing platelets. A list of such drugs is in the JPAC Donor Selection Guidelines.(1) Other drugs or tablets may be acceptable. However the taking of some drugs may indicate a disease which would automatically make a donor ineligible.