Common Temporary Reasons for Deferral
Many factors that prevent blood donation are only temporary. A potential donor may be asked to wait a certain period before attempting to donate again. These precautions are in place to protect the donor's health and to maintain the safety of the blood supply.
Acute Illness or Infection
If you are feeling unwell on the day of your donation, you should reschedule. This includes having a fever, flu, or a productive cough. The deferral period usually lasts until you are symptom-free for a certain amount of time, typically 24-48 hours, or until you have completed a course of antibiotics for an infection.
Tattoos and Piercings
Recent tattoos and piercings can cause a temporary deferral due to the risk of transmitting infectious diseases like hepatitis. The deferral period varies depending on local regulations and where the procedure was performed. In many states, if a tattoo was applied in a licensed facility using sterile, single-use needles and ink, there may be no waiting period. However, if the tattoo was received in an unregulated state or from an unlicensed artist, a three-month waiting period is often required.
Travel to Malaria-Risk Areas
Traveling to certain countries where malaria is prevalent can result in a temporary deferral. The waiting period is typically three months after returning from the trip. This is because it can take time for malaria parasites to show up in the blood. If a potential donor has lived in a malaria-endemic country for an extended period, a longer deferral may apply.
Recent Blood Transfusion
If you have received a blood transfusion yourself, you will have to wait before donating. The standard deferral period is usually three months.
Permanent Conditions That Prevent Donation
Some conditions result in a permanent, or indefinite, deferral, meaning a person can never donate blood. These are typically serious illnesses or exposures that pose a long-term risk to the blood supply, no matter how much time has passed.
- Positive Test for HIV: A permanent deferral is placed on anyone who has ever tested positive for HIV, the virus that causes AIDS.
- Viral Hepatitis: Individuals who have ever tested positive for hepatitis B or hepatitis C are permanently deferred, even if they never became ill from the infection.
- Certain Cancers: Most blood cancers, such as leukemia and lymphoma, result in permanent deferral. Other forms of cancer may require a waiting period after successful treatment.
- Chronic Diseases: Some chronic diseases, particularly those affecting the heart, may result in permanent deferral depending on the severity and treatment history.
- Injectable Drug Use: A history of injecting non-prescribed drugs can lead to a permanent deferral due to the high risk of bloodborne infections.
Medications and Blood Donation
Many medications do not affect eligibility, but some require a deferral period. It is important never to stop taking prescribed medication in order to donate blood.
- Blood Thinners (Anticoagulants): Donors on blood thinners like warfarin (Coumadin) or dabigatran (Pradaxa) cannot donate blood because of the risk of bleeding complications for themselves.
- Isotretinoin (Accutane) and Finasteride (Propecia/Proscar): These medications require a deferral period after the last dose due to potential harm to a fetus if the donated blood is given to a pregnant woman.
- HIV Prevention Medications: Individuals taking oral pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) must wait three months after their last dose. For injectable PrEP or PEP, the wait is two years.
- Psoriasis Medications: Some powerful medications for psoriasis, like acitretin (Soriatane) and etretinate (Tegison), can result in a permanent or multi-year deferral.
The Role of Hemoglobin Levels
Before donation, blood centers measure your hemoglobin level, the protein in red blood cells that carries oxygen. If your levels are too low, you will be deferred. This is to protect the donor from feeling weak or unwell after donating and to ensure the blood is effective for the patient. Low hemoglobin, often caused by an iron deficiency, is one of the most common reasons for deferral.
Other Lifestyle and Health Factors
In addition to the above, there are other criteria that determine eligibility. These are assessed during the confidential health history questionnaire before every donation.
- Age and Weight: Donors must meet minimum age and weight requirements, which can vary by state and blood center.
- Blood Pressure and Pulse: Your blood pressure and pulse are checked during your mini-physical. Readings outside of acceptable limits will lead to a deferral until they are stable.
- Recent Pregnancy: Pregnant women are not eligible to donate. There is a waiting period, typically six weeks, after giving birth before a woman can donate blood.
- Sexual Activity: Certain sexual activities, particularly with new or multiple partners involving anal sex, can result in a three-month deferral to protect against the transmission of infectious diseases.
Comparing Temporary and Permanent Deferrals
To better understand the different types of deferral, here is a comparison:
| Feature | Temporary Deferral | Permanent (Indefinite) Deferral |
|---|---|---|
| Duration | Days, weeks, or months | Lifelong |
| Cause | Conditions that resolve over time (e.g., cold, tattoo, travel) | Conditions that are high-risk or do not resolve (e.g., HIV, hepatitis C, injectable drug use) |
| Reason | Protects the donor during recovery or allows a window for disease detection | Protects the recipient from life-threatening bloodborne infections |
| Example | Waiting three months after a tattoo | A history of viral hepatitis |
Conclusion: The Importance of Donor Screening
Donation eligibility rules, though sometimes frustrating, are a critical component of blood safety. They are designed to protect both the generosity of the donor and the health of the recipient. While finding out you can't donate can be disappointing, it is essential to remember that these rules are based on rigorous medical and scientific guidelines. If you are deferred, often you can return to donate in the future once the waiting period has passed. Blood donation centers, such as the American Red Cross, provide detailed and regularly updated eligibility criteria to help potential donors understand the guidelines and prepare for their next appointment. If you are ineligible, consider other ways to support blood drives, such as volunteering or encouraging others to donate.
