Changes to Blood Donor Deferral Criteria
On 16th January 2017, a number of changes in blood donor deferral criteria took effect. There has been a long-running public discussion regarding the advisability of any change in the lifetime deferral as blood donors of men who had sex with men (MSM). The Irish Blood Transfusion Service (IBTS) organised an international conference on this subject in April 2016. I attended that conference and spoke on behalf of the haemophilia patient community and other patients who rely on blood or blood products. Our view at that time was that any change from a lifetime deferral should only be countenanced if this did not result in any increased risk to blood recipients. Our concern was not regarding the transmission of currently well-known viruses such as HIV or hepatitis B or C, for which there exist rigorous tests. Our concern was centred around the potential for a newly emerging virus, which could be transmissible via blood and which would potentially be present at a higher prevalence in the MSM population. Those at risk for such an emerging virus among the MSM community would have been more likely to have been exposed to sexually transmitted infections (STI). Therefore, the decision taken by the IBTS to decrease the lifetime deferral of MSM donors to a 1 year deferral after last having sex, when linked to a new 5-year deferral for several common STI’s (in addition to the existing lifetime deferral already in place for some STI’s notably, syphilis and gonorrhoea) is a proportionate and reasonable decision in our view, which will not negatively impact the safety of the blood supply.
On the same date, following representations from the Society and haemophilia clinicians, a donor deferral question referring to haemophilia which was outdated, was removed. Up to that date, potential donors were asked several questions referring to their sexual history in the past 12 months. These included:
In the past 12 months, have you had sex with:
• Anyone who has HIV or hepatitis?
• Anyone with haemophilia or other blood clotting disorders, who has ever been treated with clotting factor concentrates?
Since the last transmission of HIV to a person with haemophilia in Ireland occurred in 1987 and the last transmission of hepatitis C took place in 1991, this question is now redundant. Sexual partners of people with haemophilia are no longer deferred as blood donors unless the person with haemophilia has HIV or hepatitis, in which case the earlier question applies. Consequently, there is no requirement for this question relating to haemophilia and we are pleased to see it removed