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# Transfusion - Whole blood and components

## Essential information

Obligatory
  1. Must not donate if:
     At any time the donor has:
     1. Received, or thinks they may have received, a transfusion of blood or blood components in a country endemic for malaria or South American trypanosomiasis.
     2. Received treatment with blood derived coagulation factor concentrates. This includes prothrombin complex to reverse over-anticoagulation.
  2. Must not donate if:
     Since 1 January 1980:
     1. Anywhere in the world, the donor has received, or thinks they may have received, a transfusion with red cells, platelets, fresh frozen plasma (FFP), cryoprecipitate, cryodepleted plasma, convalescent plasma, granulocytes, buffy coat preparations, intravenous or subcutaneous human normal immunoglobulin. This includes mothers whose babies have required intra-uterine transfusion.
     2. Has had a plasma exchange performed.
Discretionary
  1. If:
     1. On medical inquiry, it is unlikely that the donor has been transfused, accept.
     2. Treatment with human immunoglobulin has been limited to specific immunoglobulin given as prophylaxis (e.g. anti-D, anti-tetanus or hepatitis immunoglobulin etc), accept.
  2. Autologous transfusion in:
     1. United Kingdom
     2. North America
     3. Australasia
     4. Western Europe (at any time)
     5. EU member states (from February 2005)
        If only the donor's own blood has been used, accept.
  3. Donor transfused before 1 January 1980:
     1. If before 1 January 1980, the donor received, or thinks they may have received, a transfusion in a country endemic for malaria or South American trypanosomiasis, check the Geographical Disease Risk Index. If transfused in an at-risk country, and a validated malarial antibody test and/or (as appropriate) a validated test for T. cruzi antibody is negative, accept.
     2. If the transfusion was not within a risk area for either malaria or South American trypanosomiasis, accept.

## Supporting information

See if relevant
  - Bleeding disorder
  - Geographical Disease Risk Index
  - Immunodeficiency
  - Immunoglobulin therapy
  - Malaria
  - Prion-associated diseases
  - South American trypanosomiasis
Additional information

  Transfused donors have previously contributed to the spread of some diseases. This happened with hepatitis C.

  Transfusions in some countries may have put the donor at risk of malaria or South American trypanosomiasis. It is necessary to exclude these infections before accepting the donor.

  Coagulation concentrates:

  People who have received blood derived coagulation concentrates (these are made from the blood of many donors) may have been put at risk of infections that can be passed through blood.

  Donors transfused since 1980:

  In the autumn of 2003, a UK recipient of blood, taken from a healthy donor who later developed variant Creutzfeldt-Jakob disease (vCJD), died from vCJD. Since then there have been several cases of infection with the vCJD prion in recipients of blood from donors who have later developed vCJD. In view of this, people transfused, or possibly transfused, since 1980 are now excluded from donation. This date is before bovine spongiform encephalopathy (BSE), which is believed to have caused vCJD, was prevalent.

  Plasma exchange results in a patient being exposed to multiple donors. In view of the increased vCJD risk, donations may not be taken from individuals who have had a plasma exchange performed since 1980.

  Donors transfused before 1996 (Infected Blood Inquiry):

  The Infected Blood Inquiry (2024) recommended that anyone who received a transfusion before 1996 should be offered hepatitis C testing, unless they have already been tested.

  Advise the donor to discuss/seek testing for hepatitis C with their GP or another clinical service if:

  - They were transfused before 1996, and
  - They are currently deferred from donating blood, and
  - They have not been tested for hepatitis C by a healthcare provider since, and
  - They have not donated blood since the start of 1996.

  Donors who are accepted to donate do not need to see their GP as their blood will be tested as part of routine blood donation screening.

  This entry reflects guidance from the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) and its predecessor, the Committee on the Microbiological Safety of Blood Tissues and Organs of the Department of Health.

Reason for change:
  Addition of guidance for the management of previously-deferred donors, following the recommendation of the Infected Blood Inquiry (2024) regarding hepatitis C testing.
Version details:

  WB-DSG Edition 203 Release 75 (17 February 2025)

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