# Presentation: 264490

## Some Observations on the Deferral of Volunteer Blood Donors for nvCJD Risk

**Some Observations on the Deferral of Volunteer Blood Donors for nvCJD Risk**

**Merlyn H. Sayers, M.B., B.Ch., Ph.D.**
**Carter BloodCare**
**Dallas/Fort Worth, Texas**
**and**
**Department of Pathology**
**UT Southwestern Medical Center**

## Daily 40,000 Americans donate.  Their health history, screening for markers of diseases potentially transmissible by transfusion and subsequent counseling, when indicated, constitutes the largest public health  exercise in the country.

Locally, Carter BloodCare registered 270,000 donors in 2002.  40,000 were deferred, either permanently or temporarily.

**Daily 40,000 Americans donate.  Their health history, screening for markers of diseases potentially transmissible by transfusion and subsequent counseling, when indicated, constitutes the largest public health  exercise in the country.**
**Locally, Carter BloodCare registered 270,000 donors in 2002.  40,000 were deferred, either permanently or temporarily****.**

## Subsequent Conduct of Deferred Donors

**508 Temporarily deferred donors were followed for two years:**
**297****	****(58.5%)    returned to donate, successfully**
**41****	****	****(8.0%)      returned, only to be deferred again**
**170****	****(33.5%)    did not return**
**McNab, McClurken, Sayers, *****Transfusion***** (1996) 36, 68s.**

## The Donor Questionnaire:  Increasing Scrutiny

- (Questions from CFR, FDA Memos and Guidelines, and AABB Standards and Technical Manuals)

## nvCJD DeferralCarter BloodCareNumber of Donors DeferredCumulative

## nvCJD DeferralCarter BloodCareNumber of Previous DonationsCumulative

## Some Questions Posed by Donors Deferred For nvCJD Risk

**What should I tell my wife/husband/children/ dentist/family practitioner?**
**Where can I be tested/treated?**
**Will this effect my medical insurance/disability insurance/life insurance?**
**Will this count as a pre-existing condition?**
**Should I reconsider having a family?**

## Why do the criteria change?
So if I had been in the UK for one day short of three months, I’d be safe?
If you are telling me I can’t donate any more, what are you telling patients who got my blood?
Why didn’t I hear about this from the military?
How many patients have got this disease from my blood?

**So if I had been in the UK for one day short of three months, I’d be safe?**
**If you are telling me I can’t donate any more, what are you telling patients who got my blood?**
**Why didn’t I hear about this from the military?**
**How many patients have got this disease from my blood?**

**Some Questions Posed by Donors Deferred For nvCJD Risk (Continued)**

## Percentage of Deferrals that arePermanent

## In Closing

**For many deferred donors there is a credibility gap that our explanations do not bridge.**
**To avoid the risk of transfusion safety being achieved at the expense of blood availability, CBER’s Blood Action Plan (July 1997) which addresses “increasing the blood supply” and “removing restrictions to safe donation”, needs our enthusiastic support.**
**It is easy to add eligibility restrictions (recent examples concern small pox, SARS, West Nile Virus) but the more difficult task of lifting restrictions that no longer serve a purpose must be addressed.**