Blood donor eligibility

[PinkyMacGodess]

I attempted over a decade ago to donate blood, but nobody wants mine because I lived in the UK before 1996. Even though my blood hasn't been touched by red meat in twenty years, never been in hospital, never had an infection worse than flu and pumps through a heart that runs 25 miles a week. Apparently the UK is getting along fine with all their mad-cowed blood donations coursing through the veins of patients. I guess maybe dying eventually from a disease that might not even be there is the preferred choice to dying immediately because the blood supply ran out. Pfft, your loss America. I'll still get yours.

CJDV has been in the American food chain, and that makes this whole 'Brits are excluded' rather strange.

Industry has ritualistically slaughtered *anything*, meaning sick cows, animals unable to walk (downer cattle), animals with open sores and broken bones.

The American red meat system is so corrupt and riddled with bribes, payoffs, and the worst in my mind: 'Self Inspecting Slaughterhouses'.

That last one should make everyone swear completely off American beef. Yes, the government, distracted by the Cattleman Beef Association's 'free speech' has written laws and regulations calling for the actual slaughterhouses to 'regulate themselves'. I kid you not...

'Trust us' only goes so far for me, and it's no where near THAT far. Especially for THAT industry! I gave up all red meat back about 14 years or so. I drastically cut down on pork, chicken, and turkey too. If it's not free range, and tested for no hormones and other crap, I'm not eating it.

And back to CJDV, it's caused by a 'prion', which is, I've read, smaller than a virus!!! And it just totally liquefies your brain. (Faster than election season!)

And, yeah, I can't give blood because of the French and their damned delicious yogurt and the plethora of CHEESE(!!!!) and cut meats (pork salami)... Whatever. Their loss, I guess...
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The question I'd like to see researched and addressed by the FDA in the U.S. and the equivalent organizations in other countries is this: What are the pros and cons of changing to a deferral system based on an assessment of personal risk for each individual, as opposed to the current system based on categorizations?

Would it be too expensive in time and labor? Would training screeners be prohibitively hard? Would it lead to more collection of unsafe blood? Or would it increase the overall blood supply, have no effect on safety, and eliminate all of the unfairness of a category-based system?

I knew a guy that was a virologist fellow, and he told me to never get a blood transfusion from the blood bank. His reasoning was that there are so many things that they don't test for, and so many things that they don't know to test for that to just take a random bag of blood out of the bank is like playing Russian Roulette. He said that before surgery, everyone should provide a few bags of their own blood, 'just in case', and someone should make sure that they use your own blood.

I think he was being a little alarmist, but I'm not in the industry (medical).

I've had family that needed several units of blood over the time in hospital, and when it's an emergency, you just can't say 'Nope!'.

They used to bar homosexuals from donating, and there were instances of people denying blood because it might be 'black blood', but *shrug*... I'd not like obese blood, or a smokers blood, but hey, you can't choose...

It will be interesting to see the developments in blood research over time.

 

[Doctor Q]

News:

Transfusions of 'old' blood may harm some patients
Maximum shelf life of red blood cells should be reduced, researchers recommend​

If this research from Columbia University is confirmed, blood banks may need to store blood for a shorter time before considering it to be ineffective. That would increase the number of blood donations required to maintain the blood supply. Eligible donors would have to donate more frequently or more eligible donors would have to be recruited.

 

[Snoopy4]

A family member contracted HIV and died six years after from a transfusion. The donor lied on the form. The blood was tested, but they later found a mixup in the documentation and the test had actually been positive.

There are many reasons people cannot give blood, if justification to deny donations is rational to ensure safety, then so be it. When it comes to people getting a blood transfusion, it's not about you or your feelings. It's about the person getting the blood and their life.

 

[Raid]

A family member contracted HIV and died six years after from a transfusion. The donor lied on the form. The blood was tested, but they later found a mixup in the documentation and the test had actually been positive.

There are many reasons people cannot give blood, if justification to deny donations is rational to ensure safety, then so be it. When it comes to people getting a blood transfusion, it's not about you or your feelings. It's about the person getting the blood and their life.

What happened to your family member is horrible, I would hope that the donor didn't know they were positive, and I hope the practices at the donation clinic and testing facilities changed to prevent this type of error from happening again. As a regular donor now I see many new people donating for the first time, just wanting to help.

I've wondered if there are people who have had or are in a situation that may risk ineligibility to donate and programs/testing put in place to encourage those people to come in and be tested for eligibility before donating. I know the feeling of being turned down; the first time I went in I was waiting for the results of a thyroid biopsy and because the diagnosis hadn't come back so I was told to wait. When it came in, the doctor cleared me and I've been donating ever since.

Since blood donation up here is strictly volunteer there's an altruistic feeling you get with it, but I agree the focus should be on the health of the recipient.

 

[Doctor Q]

Potential blood donors are still rejected in the U.S. if they lived in the U.K. during certain years, and therefore might have been exposed to variant Creutzfeldt-Jakob Disease (vCJD, the human variant of Mad Cow Disease). The ban has been in place since 2001.

Even after all this time, the FDA doesn't think it's safe to drop the restrictions, because vCJD can have a very long incubation period. The FDA also continues to consider which countries the rule should apply to. Meanwhile, millions of potential donors are excluded, which is the downside of taking these precautions.

There's a good article about the issue at Business Insider.

 

[jhwalker]

In the US, the Red Cross bars you from donating if you "are a male who has had sexual contact with another male, even once, since 1977".

The father of a friend of mine and his partner have been a monogomous, committed couple since 1980. They are each other's first and only same-sex partner. Ever. They are *FAR* safer than many people who engage in opposite-sex sexual contact. (They don't engage in any other risky behaviors, either.) Thus they have *ZERO* risk of HIV/AIDS. (Well, as much risk as any married couple that were virgins before they got married; since my friend's father's only other relationship was to my friend's mother, a marriage that lasted 2 years before he realized he was gay. They're still friends, too.)

Similar here - my partner and I have been together over 25 years, monogamous the whole time. We still get HIV tests whenever we go to the doctor (just like cholesterol, blood sugar, etc.), and have 20+ years of negative results.

Still not welcome to give blood

 

[Raid]

Potential blood donors are still rejected in the U.S. if they lived in the U.K. during certain years, and therefore might have been exposed to variant Creutzfeldt-Jakob Disease (vCJD, the human variant of Mad Cow Disease). The ban has been in place since 2001.

Even after all this time, the FDA doesn't think it's safe to drop the restrictions, because vCJD can have a very long incubation period. The FDA also continues to consider which countries the rule should apply to. Meanwhile, millions of potential donors are excluded, which is the downside of taking these precautions.

There's a good article about the issue at Business Insider.

Doc, maybe this is a good topic to refresh from time to time. How about putting links to eligibility questionnaires in the OP?
Here's the one for Canadian Blood Services and the one for Hema Quebec for the Canadians.

 

[Doctor Q]

Doc, maybe this is a good topic to refresh from time to time. How about putting links to eligibility questionnaires in the OP?
Here's the one for Canadian Blood Services and the one for Hema Quebec for the Canadians.

Good suggestion. Although we can't research the requirements for all of the over 50 countries in our FAQ, and keep it all up-to-date, we've added links for "Who Can Donate?" and the "Eligibility Quiz" you mention to the Blood and Platelet Donation FAQ.

 

[Doctor Q]

At least annualy I try to update the information in this thread, in advance of the MacRumors Blood Drive.

Long deferrals. Some countries (for example, China, Denmark, and Turkey) still have indefinite bans on blood donation by sexually active gay men, while many other countries now have 1-year deferrals. In practice, 1-year deferrals still prevent blood donation by a large number of potential donors.

No deferrals. In contrast, a numbers of countries have no deferrals at all. Instead, they assess donors based on their individual risk, a practice that many in these forums advocate. Those countries now include Mexico, Italy, Spain, Russia, Poland, South Africa, and a number of South American countries.

The U.S. The FDA has not changed their 1-year deferral policy. I don't know if the Office of HIV/AIDS and Infectious Disease Policy even met last year. They seem to have made no new recommendations last year or this year.

The U.K. As of this year, the Advisory Committee on the Safety of Blood, Tissues and Organs has changed the policy, reducing the deferral from 1 year to 3 months. A news report named Blood donation rules relaxed for gay men and sex workers says that NHS Blood and Transplant will now investigate completely eliminating the deferral period for some gay men. The minutes of the Advisory Committee meetings are public (example). For the most straightforward explanation, see the NHS Blood and Transplant FAQ.​

Updated research, as well as faster blood testing techniques, are reportedly contributing to the reduction or elimination of rules that prevent donations by members of statistically-higher-risk groups. But the disparity among countries is still large.

 

[TC_GoldRush]

Wow thank you! You even listed the petitions I have to sign against! Its fact that HIV/AID rates run much much higher in gay (male) couples than hetero couples. Major liability risk there.

 

[A.Goldberg]

I would hope to see a day when gay people can donate blood. I suppose at this time the highest rate of HIV/AIDS in the US is in the gay community. It’s also worth noting the incubation of HIV can be a while, so people may have the virus and not know it. In that there are plenty of people with theoretically a lower risk of having HIV, who are able to donate blood, I guess it makes sense to go with the lowest risk pools.

HIV treatment has made tremendous strides in the past several decades. It’s truly a testament to human ingenuity and medical technology. With treatment, pre-exposure prophylaxis, and condoms, the risk of transmission is virtually zero. I strongly believe HIV can be essentially eradicated in the future on that fact a lone. In that case, there should be a day, in the not so distant future, when gay people can donate blood.

 

[Doctor Q]

Since my status report above, news outlets report that Denmark will change their deferral for sexually active gay men from an indefinite deferral to a 4-month deferral.

The current 4-month quarantine rule in Denmark applies to bisexual man, people who are HIV positive, prostitutes, and people from geographical areas where HIV occurs widely in the population (sub-Saharan Africa, Southeast Asia and South America). Sometime this year, sexually active gay men will reportedly be added to that list, replacing the permanent exclusion.

 

[pshufd]

I can't give blood because I traveled to England around 85-86 and it's for fear of BSE. I've also been treated for cancer and some of the chemo drugs stick around for a long time - maybe forever.

 

[Doctor Q]

According to a post by user Timelordprime, Canada is reducing the deferral for gay or bi-sexual men from 1 year to 3 months, and is working toward eliminating the deferral completely.

 

[Doctor Q]

This month (April 2020) the U.S. Food and Drug Administration, which sets blood donation guidelines, temporarily reduced the MSM deferral from 12 months to 3 months for the duration of the coronavirus pandemic. Certain other restrictions, including for travel to certain countries, was also reduced to 3 months.

See the FDA statement.

 

[Doctor Q]

The British National Health Service's Blood and Transplant department announced a major change to their blood donor eligibility policy. Starting next summer, men (and women) who have had sex with only one partner (male or female) for at least three months will be eligible donors.

Male potential donors will no longer be asked if they have had sex with another man in the interview or questionnaire.

There will still be restrictions for people who have multiple partners, take certain drugs, were exposed to certain diseases, or engage in practices that are too risky. The bottom line is that eligibility for everyone, including gay and bisexual men, will be based on individual circumstances rather than on broad exclusions.

Guardian article: Blood donor rules to be relaxed for gay and bisexual men in England

 

[Khalanad75]

The US has changed their deferrals for those who live in Europe during the 80s and 90s.

So I can once again give, and since I have AB+, I am all set to start giving plasma on the regular once my deferral flag lifts in the system.

 

[bunnspecial]

The British National Health Service's Blood and Transplant department announced a major change to their blood donor eligibility policy. Starting next summer, men (and women) who have had sex with only one partner (male or female) for at least three months will be eligible donors.

Male potential donors will no longer be asked if they have had sex with another man in the interview or questionnaire.

There will still be restrictions for people who have multiple partners, take certain drugs, were exposed to certain diseases, or engage in practices that are too risky. The bottom line is that eligibility for everyone, including gay and bisexual men, will be based on individual circumstances rather than on broad exclusions.

Guardian article: Blood donor rules to be relaxed for gay and bisexual men in England

The "risk based assessment" based on sexual partners seems like a much more sound idea all around than the current restrictions.

As I understand it(and I could be wrong), anal sex in general is much, much higher risk for HIV transmission than other penetrative types of sex, and of course that is not the exclusive domain of men having sex with other men.

Long term monogamous partners who are both HIV- should have no risk of transmission of HIV(or at least I can't think of any reason why they would). On the other hand, it's always a risk with promiscuous behavior regardless of the gender of the people involved.

On another note, I could have sworn that Epstein-Barr virus was a lifetime deferral, or at least it seems like I remember it use to be prescreening question. Before a few weeks ago, I hadn't donated since spring of 2019, but my wife(who had never donated) wanted to a few weeks ago and I went with her. She had mono as a teenager, and I warned her that she might get disqualified, but it didn't come up in Rapid Pass questions(and on another note, after giving whole blood and having an overall great experience, she's onboard and we're both going to give platelets on Friday).

 

[Doctor Q]

U.K.

As of June 14, 2021 (World Blood Donor Day), the National Health Service (NHS) has changed the blood donor eligibility rules for England, Scotland, and Wales. Eligibility is now based on individual circumstances and MSM will no longer be an eligibility question. Instead, anyone who has had the same sexual partner for the last 3 months will be eligible to donate if they meet all of the other qualifications.

U.S.

The U.S. Food and Drug Administration (FDA) has begun a study of similar eligibility changes in 8 major U.S. cities. The study, called Assessing Donor Variability And New Concepts in Eligibility (ADVANCE), will assess whether measuring individual risk is equally effective for blood safety as the time-based deferrals that have been in effect since 1983 (a lifetime deferral from 1983 to 2015, a 12-month deferral from 2015 to 2020, and a 3-month deferral since then).

Even if the results are promising, the FDA may expand the scope of the study before making policy changes that would bring U.S. eligibility in line with the NHS rules.

Donors in the ADVANCE study won't actually donate blood to patients. Instead, they'll fill out surveys and have their blood tested. They will be paid for their participation, a controversial practice when it comes to regular blood donors, since paying donors may encourage ineligible donors to pretend they are eligible.

 

[Doctor Q]

Two week ago, 22 U.S. Senators sent an open letter to the Secretary of the Department of Health and Human Services and the Acting Commissioner of the FDA:

...​

The Red Cross, America’s Blood Centers, and AABB, formerly the American Association of Blood Banks, have declared a nationwide blood supply crisis for the first time, as the nation experiences its worst blood shortfall in over a decade.​

...​

While no single solution can fully solve these challenges, the FDA has the ability to take a simple and science-based step to dramatically increase the donor base and help address this crisis.​

...​

[A]ny policy that continues to categorically single out the LGBTQ+ community is discriminatory and wrong. Given advances in blood screening and safety technology, a time-based policy for gay and bisexual men is not scientifically sound, continues to effectively exclude an entire group of people, and does not meet the urgent demands of the moment.​

...​

[W]e must adopt evidence-based policies focused on assessment of an individual’s risk, not inaccurate and antiquated stereotypes.​

...​

 

[Doctor Q]

This month (April 2022), Health Canada announced an end to restrictions applied only to MSM. Starting on or before September 30, 2022, all blood donors will be given the same screening.

Screening will still involve questions about sexual behavior, but for everyone.

Although donated blood is screened for detectable diseases, not all infections can be detected. That's the reason for the screening questions.

 

[PinkyMacGodess]

I was told I couldn't donate because I traveled in Europe and ate cheese and other 'forbidden things' while there.

Is that still a thing for donating blood? I found it ridiculous at the time, but was turned away no the less. (Punishment from the American beef and dairy industry? Weird)

 

[Doctor Q]

Spending time in certain countries during certain time periods could have exposed you to infectious diseases that might, just might, increase the risk of a problem with your blood that wouldn't show up during normal blood screening.

I'd think that each of those dangers (like Mad Cow Disease, which peaked around 1992 in the U.K.) would fall off the cautionary list after a while, but I think the overly risk-averse nature of the blood donor screening rules keep them around much longer than necessary.

I've never been asked about eating cheese. That one's a surprise to me!

 

[PinkyMacGodess]

Spending time in certain countries during certain time periods could have exposed you to infectious diseases that might, just might, increase the risk of a problem with your blood that wouldn't show up during normal blood screening.

I'd think that each of those dangers (like Mad Cow Disease, which peaked around 1992 in the U.K.) would fall off the cautionary list after a while, but I think the overly risk-averse nature of the blood donor screening rules keep them around much longer than necessary.

I've never been asked about eating cheese. That one's a surprise to me!

I thought it odd too. 'Have you traveled to a European country?' Yes. 'Did you eat any meats and/or dairy products?' Oh heck yes! No meat (vegetarian) but in the hotel I stayed at they had this amazingly delicious French yogurt. I ate as much of that as I could each morning! OMG! It was so delicious! They looked at me as if I was a leper. 'OH NO! You can't donate blood! You can't donate blood ever again! (they almost shrieked) You have to leave!'

What??? Eating French yogurt is a crime?

They were also denying European meat eaters too. (Europe at the time wouldn't import American beef because of their fear that US beef could be tainted with mad cow. Likely a game, but there had been a few cases in this country of it possibly linked to beef at the time)

*shrug* One time I gave blood and had a bruise because she hunted for the vein that covered nearly the entire inside of my upper arm. Yikes...

But I guess, in case it's still 'valid' and people are so weird about it, I just say 'Nope. No meats/cheese/yummy French yogurt?.' I was just curious if anyone else had experienced that issue. I'd imagine that by the time I had tried to donate, anything I would have possibly been exposed to was long gone. TMI? Apparently. It was just weird...

 

[Doctor Q]

2023 U.S. update

Long-requested changes to donor eligibility rules may be coming.

In January 2023, the U.S. Food and Drug Administration (FDA) issued a draft:

Recommendations for Evaluating Donor Eligibility Using Individual Risk-Based Questions to Reduce the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products​

The draft says

We recommend eliminating the time-based deferrals for men who have sex with men (MSM) and women who
have sex with MSM. Instead, we recommend assessing donor eligibility using gender-inclusive, individual risk-based questions relevant to HIV risk.​

In other words, under these recommendations, a gay man in a monogamous relationship would be judged on the same basis as a straight man in a monogamous relationship. Both would be considered at potentially higher risk if they recently had a new sexual partner or more than one sexual partner, and lower risk otherwise.

The recommended changes would affect screening procedures by U.S. blood donation centers, including the Red Cross. Changes would be made to donor educational materials and donor history questionnaires. The eligibility of donors who were deferred under the previous guidelines would be re-evaluated.

In March 2023, the U.S. Red Cross issued a statement supporting exactly these types of changes. It remains to be seen if and when the recommendations will become official.