NATIONAL BLOOD TRANSFUSION SERVICE

SRI LANKA
WHOLE BLOOD & COMPONENT DONOR SELECTION
GUIDELINES

Dr. Anoja Herath

Consultant Transfusion Physician
Teaching Hospital Kalutara
Policy recommendations -WHO
• Each country should establish a national system for blood donor
selection for the donation of blood or blood components.
• All blood donors, should be assessed, prior to blood collection, for
their suitability to donate on each occasion of donation
• National donor selection guidelines and criteria should be based on
epidemiological and/or scientific evidence or, where evidence is
limited or lacking, on best practices.
Policy recommendations -WHO
• Donor acceptance and deferral policies for the prevention of TTI
should be based on up-to-date information on the local epidemiology
of infections, the markers screened for, the availability of suitable
blood screening and confirmatory assays, and the technologies in use.
• Blood transfusion services should have mechanisms for surveillance
to monitor emerging infections and diseases associated with
transmission through transfusion, and assess the risk of transmission
and the possible consequences to the blood supply of excluding “at-
risk” donors.
Policy recommendations -WHO
• National donor selection criteria should define conditions of
acceptance and deferral for each criterion.
• Blood transfusion services should establish mechanisms for
monitoring and evaluation to assess the implementation and
effectiveness of donor selection criteria.
 NATIONAL BLOOD TRANSFUSION SERVICE
SRI LANKA
WHOLE BLOOD & COMPONENT DONOR SELECTION GUIDELINES

• References:
• World Health Organization, Blood donor selection: guidelines on assessing donor
suitability for blood donation, 2012
 
• United Kingdom Blood Transfusion Services (UKBTS), Whole Blood and
Component Donor Selection Guidelines (WB&CDSG) Edition 203, Release 44,
2019

• Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services
Professional Advisory Committee, Care and selection of whole blood and
component donors, 2021
Donor Selection Process
• General Questions
medication, transfusion, family history, adverse events after previous donation
• Infections
past history, contact, vaccination
skin piercing –acupuncture, tattoos, inoculation injury
• Medical/Surgical conditions
• Life style questions
risk activities – sex & drugs
• Travel
Donor Safety
• Age limits for blood donation
Accept (both male and female)
First time blood donors - 18 to 55 years
  Regular donors -18 to 60 years
• Weight
Prospective donors of whole blood donation or blood component/s
donation by apheresis should weigh minimum of 50 kg at the time of
donation.
Prospective donors of double red cell apheresis donations should have
70 kg or more at the time of donation.
Haemoglobin level for blood donation
Accept
• Whole blood and platelet apheresis donors- ≥12.5 g/dl for both male and female
• If the haemoglobin concentration for males is ≥18.0 g/dl and for females is ≥16.5 g/dl
and Polycythaemia Rubra Vera has been excluded,
• Double Red Cell apheresis donors- ≥16.0 g/dl.

Defer if the haemoglobin concentration is greater than:

• Female donors: ≥16.5 g/dl
• Male donors: ≥18.0 g/dl until the cause has been identified.
* If the Hb level was found to be less than 12.5g/dl at the donation site, consider
referring for further investigations.
Frequency of donation
Accept
Whole blood donation- After 04 months
Double red cell Apheresis donation-After 06 months.
Apheresis platelet and plasma donation- After two (02) weeks
(allowed maximum of 24 donations per year)
Whole blood donors changing to platelet donation and apheresis platelet donors returning to whole
blood donations from previous donation should wait for a minimum four (04) weeks.
Cardiovascular diseases
Accept
• Corrected simple congenital cardiac malformations with no residual
symptoms.
• Asymptomatic disorders such as functional murmurs and mitral valve
prolapse
• Accept myocarditis 1 year after full recovery
• Accept asymptomatic hypercholesterolemia with no CVS or CNS
involvement on treatment
Defer permanently
• Symptomatic ischemic heart disease
• Symptomatic peripheral vascular disease, including history of arterial thrombosis
• History of myocardial infarction
• Severe cardiac arrhythmia
• Rheumatic fever with evidence of chronic heart disease
• Acquired valvular disease with stenosis or regurgitation
• Valve replacement
• Hypertrophic cardiomyopathy
• Palliated (i.e. uncorrected) congenital heart disease
• Bundle branch blocks
Blood Pressure
Accept
• systolic BP of 100–140 mmHg and diastolic BP of 60–90 mmHg
* Recheck in two occasions at least 15 minutes apart and if repeatedly high, defer and refer for
medical advice.

Hypertension
Defer if controlled by medication.

Hypercholesterolaemia
Accept if not led to symptomatic disease, even if on treatment
 Defer has caused symptomatic disease, associated with CVS or CNS disease.
Respiratory Diseases
Defer
• Acute upper respiratory infection for 07 days following full recovery
and completion of therapy, including antibiotics.
• Pneumonia for 3 months from full recovery and completion of
antibiotics
 
Defer permanently if breathless at rest or minimal exertion or if
cyanosed, has severe obstructive airways disease including if on long-
term oral steroid therapy, or chronic or recurrent respiratory infection.
Bronchitis
• Defer for 07 days after full recovery from acute attack and completion of treatment

Asthma
• Accept asymptomatic or on regular preventive treatment including inhale steroids 
• Defer if symptomatic.
• Defer for 6 months
• On or has completed a course of oral or injected steroids lasting more than 3 weeks
• On long term (six months or more) treatment with oral or injected steroids within the last
12 months.
• On a short course (less than three weeks) of oral or injected steroids in the last seven days.
• Rhinitis, Catarrh, Sinusitis
Accept
If not on antibiotics for the past 7 days or even on antihistamines
and symptomatic treatment.
Diabetes Mellitus
• Accept if diabetes mellitus controlled by diet.
• Defer permanently
Requires injectable or oral treatment
Complications with multi-organ involvement.
Surgery
Defer
• For 03 months following minor surgery until treatment is completed and successful and normal activity
resumed.
• For 06 months following major surgery.
• All wounds are not healed.
• Any infection.
• Normal mobility has not been regained.
• Requiring post-operative treatment or attending hospital regularly.
• Awaiting surgery 
 
Defer permanently
• Following neurosurgical procedure, dura mater graft or corneal transplant.
• Surgery is for malignancy
Diagnostic procedures
• Accept following minor diagnostic procedure including colposcopy or
rigid/capsular endoscopy after normal activity resumed and if not
waiting for further tests or results.
• Defer for 6 months following invasive diagnostic procedure using
flexible endoscopy.
Pregnancy
• Defer
• If Pregnant.
• Less than 1year have passed since delivery
Abortion
• Defer for 6 months of completion of treatment or follow up for a non-malignant (non-invasive)
hydatidiform mole.
• Defer permanently for malignant (invasive) hydatidiform mole.

Breast feeding
• Accept after one year of child birth even with breast feeding provided the Hb is within
acceptable level
Renal Diseases
• Accept if fully recovered from acute self-limiting condition (e.g. acute
nephritis) provided renal functions are normal:
• Defer
• Individuals with lower urinary tract infections: defer for 7 days after
full recovery and completion of treatment
 
• Defer permanently
• Individuals with chronic renal disease-causing ill-health or anaemia, or
associated with chronic or recurrent infection
Central Nervous System Diseases
Accept 1 year after complete recovery of acute demyelinating neurological
diseases
Eg: GBS, Transverse Myelitis
Defer permanently
• Cerebrovascular disease including history of transient cerebral ischemic
episodes or stroke
• Dementia(Alzheimer's disease) or Parkinsons neurodegenerative disease
due to any cause
• Multiple sclerosis or other demyelinating diseases
• Epilepsy
Haematological Diseases
Coagulation disorders
Accept asymptomatic carrier for haemophilia A or B provided normal
coagulation factor levels and no history of bleeding or treatment with
blood products.
 
Defer permanently
• Individuals with inherited or acquired coagulation factor deficiencies
• On regular treatment with plasma-derived coagulation factors
Thrombosis
• Accept
• Identified as having a thrombophilic condition, but with no history of a thrombotic episode, and are not
on anticoagulant treatment.
• Had a single episode of deep vein thrombosis or pulmonary embolus with an identifiable cause, provided
that they are fully recovered and anticoagulant therapy has been stopped for at least one month.
• Had a single episode of thrombophlebitis in the last 12 months, provided they are otherwise well and off
treatment for at least 7 days.

• Defer permanently
• Two or more episodes of venous thrombosis requiring treatment.
• Axillary vein thrombosis or thrombophlebitis affecting the upper limb
• Two or more episodes of thrombophlebitis in the last 12 months
Haemoglobinopathies
• Accept
• Thalassaemia traits, provided they are well and meet the minimum
haemoglobin level for blood donation
• Defer permanently
• If diagnosed with Thalassaemia major, sickle cell disease, sickle cell
trait and Thalassemia variants other than Thalassemia trait
Erythrocytosis
• Accept secondary erythrocytosis. (Eg: smoking)
• Defer permanently if diagnosed with polycythaemia rubra vera
Essential thrombocythaemia
• Defer permanently
Myelodysplastic syndrome
• Defer permanently
Platelet disorders
• Accept
• More than 5 year after an acute autoimmune thrombocytopenia, provided they are well and no longer require
treatment, other than prophylactic antibiotics following splenectomy.
• Defer permanently
• Individuals with thrombocytopenia of unknown cause or associated with long- term haematological or systemic disease.
Splenectomy
• Accept
• If for trauma, when recovered, even if taking prophylactic antibiotics,
• If for immune thrombocytopenia, if at least five years from recovery,
even if taking prophylactic antibiotics. Refer Platelet Disorders
• Defer
• For malignancy.
• For a myeloproliferative disorder.
• For haemolytic anaemia.
Skin Diseases
Accept
• Individuals with common skin conditions, such as:
Mild eczema
Mild acne
Mild psoriasis
• Provided lesions are not infected, there are no systemic symptoms, the venepuncture site is unaffected and they have not received
immunosuppressive or retinoid treatment;
• Long-term low-dose antibiotic treatment for acne is not a contraindication to blood donation.
• Individuals with burns, when fully healed.
Defer
• Individuals with:
• Psoriasis with infected lesions, systemic symptoms, affected venipuncture site or receiving immunosuppressive or retinoid
treatment.
• Generalized skin disease(s) on systemic medication.
• Contagious skin diseases such as scabies and ringworm until cleared
• Unhealed skin ulcers and skin wounds
Defer permanently
• Individuals with systemic diseases affecting the skin, such as:
Scleroderma
Systemic lupus erythematosus
Dermatomyositis
Systemic cutaneous amyloidosis
Alopecia
• Defer for 7 days from the last dose of systemic antibiotic or anti-
fungal treatment or autologous PRP
• Defer for 1 month from the last dose of Finasteride (Propecia®,
Proscar®)
• Defer for 6 months from the last dose of Dutasteride (Avodart®)
Psychiatric Disorders
Accept
• Individuals are well on the day of donation and have the mental
capacity to give full informed consent.

Defer permanently
• Individuals with psychotic disorders requiring maintenance treatment
Allergy
• Accept if free of symptoms
• Defer for 7 days from last dose of oral or injected steroids
• Defer permanently if history of anaphylaxis
Rheumatic fever
Defer
• Less than 24 months from any symptomatic disease.
• On Benzathine penicillin prophylaxis
 
Defer permanently
• Caused permanent heart valve damage
Arthritis
• Accept 7days after completion of NSAID therapy or autologous PRP
therapy
• Accept 3 months after completion of treatment with disease
modifying drugs
Eg: Methotrexate
Autoimmune Diseases
• Accept for mild disease and or not on treatment including vitiligo,
psoriasis and thyroiditis
• Defer
The donor has needed treatment to suppress the condition in 
the last 12 months.
The cardiovascular system is involved.
GI disease
Accept
• Individuals with:
• Diverticular disease, if well
• Mild gastro-oesophageal reflux
• Mild hiatus hernia
• Coeliac disease
• Gallstones
• Irritable bowel syndrome without debility.
Defer
• Active peptic ulceration, until completion of treatment and full recovery.
Defer permanently
• Active inflammatory bowel disease (ulcerative colitis or Crohn's disease)
• Individuals with malabsorption syndromes (except coeliac disease)
Thyroid Disorders
Accept
• Benign hypothyroidism and presently euthyroid (with or without treatment).
• If on stable maintenance thyroid replacement therapy (thyroxine) and there have been no dose changes in the last
4 weeks.
 
Defer
• Under investigation for thyroid disease, (hyper- or hypo-thyroid)
• Less than 6 months from treatment with radioactive iodine therapy.
• Less than 24 months from stopping treatment with anti-thyroid tablets.
• Less than 8 weeks since commencing thyroid replacement therapy (thyroxine).

Defer permanently
• History of thyrotoxicosis due to Graves' disease.
• History of malignant thyroid tumors
Medications
Accept long-term low-dose antibiotics for acne.
Defer
• for 07 days following antibiotics, aspirin and non-steroidal anti-inflammatory
drugs, Retinoids
• For 3 years following Acitretin
• For one (01) month following Isotretinoin
• For 6 months following Dutasteride
• for one (01) month following Finasteride
* Take account of indication for treatment
* For other drugs consider safety of donor and recipient
• Antibiotics
Accept
Prophylactic antibiotic therapy, according to the underlying disease
condition
7 days after completion of treatment.
 
* Treatment with antibiotics is not of itself a reason for deferral
but the reason for the treatment may be
Anticoagulant therapy
• Accept 7 days after completion of treatment for isolated DVT or PE
• Defer permanently Anticoagulant therapy for recurrent venous or arterial thrombosis.

Non steroidal Anti-inflammatory Drugs (NSAID)

• Accept
• If more than 7 days from the last dose, taken for an acute illness.
• Defer
• If taken for a serious long-term illness including cardiovascular disease, osteoarthritis
etc.
Oral Contraceptives
• Accept

Menstruation
• Accept if not heavy unusual bleeding

Menopause
• Accept
• Even on hormone replacement therapy (HRT) or other treatment to control
menopausal symptoms
• Fever (non specific)
Defer for 14 days after full recovery.
Defer for 1 month for long standing fever (more than 07 days) after full
recovery.

• Temperature
Defer
• Temperature more than 37.8°C (1000F)
* Fever can indicate any number of medical conditions and infections, but is
usually associated with other symptoms
• Headache
Accept
• If mild and not disturbing lifestyle

Defer
• Severe headache disturbing lifestyle or not investigated
• Migraine on prophylaxis
Occupation
Defer
• If engage in Hazardous occupation with in 24 hours of donation
• Eg: Pilot, Train driver, Bus driver, Crain or machine operator, Fireman,
Air traffic controller, climbing ladders/ scaffoldings
Transplantation
• Defer permanently following stem cell or organ transplantation, dura
mater graft, corneal transplant or xenograft.
Snake bite
• Accept
• After fully recovery with no local tissue damage or infection.
• Defer
• For 1year if anti-venom treatment has been given.
• If transfused with blood components: Refer Blood Transfusion
Recipient Safety
Recipient Safety
• Prevent Transmission of infections
Viral
Bacterial
Parasites
Prions
• Diseases of unknown cause which may be transmissible
malignant and auto-immune diseases
Viruses (1)
• High risk for HIV/Hepatitis
Permanent deferral
HIV positive
Carrier for Hep B or C
IV drug use
MSM
Sex workers
multiple sexual partners
Viruses (2)
Temporary Deferral (12 months)
• Sexual contacts of high risk individuals
• Skin piercing/tattoos/acupuncture and their sexual partner
• Endoscopy
• Inoculation injury
Risk of blood
• Wrong blood to patient 1 in 20000 – 30000

• HCV 1 in 30 million
• HIV 1 in 8 million
• HBV 1 in 1 million

latest NBS/PHLS figures

Viruses(3)
• HIV/AIDS
Defer permanently
• Individuals with present or past clinical or laboratory evidence of HIV infection.
• Current or former sexual contacts of individuals with HIV infection
Defer
• If waiting for investigations or results of investigations for HIV.
 
Accept
• Household contacts of individuals with HIV infection
Viruses (4)
• Hepatitis A, hepatitis E and hepatitis of unknown origin
Accept after 12 months of full recovery in the presence of
documented evidence of Hepatitis A or E
Defer for 12 months
Individuals with active HAV, or HEV after full recovery.
Sexual contacts, household and other close contacts of
individuals with HAV, HEV or hepatitis of unknown origin.
Defer permanently Hepatitis of unknown origin
Viruses (5)
• Hepatitis B and Hepatitis C
Defer permanently
Individuals with current or past Hepatitis B and C infection.
Current or former sexual and household contacts of individuals with
active or past HBV or HCV infection
Viruses (6)
HTLV I & II
Defer permanently
• Individuals with HTLV I and/or II infection.
• Individuals whose mother or maternal grandmother has or had HTLV I and/or II infection,
• Current and former sexual contacts of individuals with HTLV I and/or II infection.
Defer
• If waiting for investigations or results of investigations for HTLV.
 
Accept
• Household contacts of individuals with HTLV I and/or II infection
Viruses (7)
• Herpes Simplex 1 and 2 Defer permanently
• Herpes Zoster Accept one month after full recovery
Viruses (8)
• Defer for 1 month
Chickenpox
Mumps
Measles
EBV
Rubella
• Defer for 6 months
Chickungunya
Dengue fever
• Common cold defer until full recovery
• Influenza
Defer for 7 days after full recovery and cessation of any therapy.

Defer if on Tamiflu for influenza prophylaxis.

 
• Covid 19
accept one month from the date of full recovery
defer - Diagnosed patient for one month from the date of full recovery
First or Second degree contact for 21 days from the date of exposure
Donors with Symptoms of COVID 19 infection But, has not been tested for one month
from the date of full recovery
Donors with close contact to a person who had a foreign travel for 21 days from the date
of exposure
Donors who are Home or Institutional quarantine and PCR is negative for 21 days from
the date of quarantine
Following RT PCR or Rapid Antigen Test (RAT)until results available
Recipients of COVID 19 vaccine- Refer vaccine
• Rabies
Accept
After 12 months,
if exposure to a potentially rabid animal has been managed with 
Immunoglobulin and vaccination, and fully cleared
by the treating physician
 
• Needle prick injury, Splashing of body fluids or mucosal contamination
Defer for 1 year following the exposure
Prion associated diseases
Defer permanently
• Familial and Variant Creutzfeldt-Jakob Disease (vCJD), and first-degree
relatives.
• History of treatment with pituitary-derived human growth hormone,
human gonadotrophin, duramater graft, corneal transplantation,
neurosurgery
Bacteria
• Dental treatment
Accept
24 hours after simple procedures (filling, scale or polish)
and
7 days after extraction, root canal treatment, dental
capping, dental implant procedures
4 weeks after full recovery if multiple teeth extraction/
complicated procedure.
Defer permanently following human tissue (bone) graft
• Diarrhea
Accept
01 month after full recovery and completion of therapy, including
antibiotics.
Chronic diarrhea due to irritable bowel syndrome without debility.
(Refer GI diseases.)
• Yersinia enterocolitica infection
Defer for 01 month following full recovery if recent abdominal
symptoms, particularly diarrhoea, suggestive of Y. enterocolitica
infection.
Streptococcus infection
Defer
For 07 days following full healing if recent superficial but significant
wounds.
For 01month following full recovery of systemic infection.

Syphilis
Defer permanently if has ever had a diagnosis of syphilis
• Tuberculosis
Defer for 2 years following confirmation of cure.
  Mantoux test:
Accept if no further investigations or treatment is planned.
• Typhoid
Defer for one month following confirmation of cure.
• Brucellosis Defer permanently
• Lyme disease Defer for 1 month following full recovery and completion
of treatment, whichever is longer
• Leprosy
Accept after 2 years of full recovery and stopping treatment
• Salmonella infection
Defer for 01 month following full recovery
• Leptospirosis
Defer for 06 months following recovery
• Hair Removal and other non-invasive cosmetic procedures
Accept unless the technique has led to wounds or infection.
Parasites
• Malaria
Defer for 3 year after full recovery
(Visit malarial endemic areas Refer: Foreign travel.)
• Leishmaniosis
Defer permanently
Individuals who ever had a diagnosis of any form of leishmaniasis
(cutaneous or visceral)
 
Defer for 1 year since their last return, who have spent extended
periods in endemic areas
• Babesiosis defer permanently
• Toxoplasmosis
Accept after 6 months of full recovery and completing antibiotics
parasitic worms
Filariasis
Defer
• For one year with active history of filarial infection which is best
detected by filarial antigen detection test.
• Continuing or
possibly continuing infection, even without symptoms or signs of infec
tion
• Chronic filariasis
Foreign Travel
• Defer for 3 months since return from a foreign country except for
malarial endemic countries
• Defer for 3 years since return from a malarial endemic country
• Defer if the donor is planning to leave the country, or is planning not
to return within the coming 3 months
• Defer if the donor is planning to fly within the next 48 hours
Vaccination
• Defer for 12 months
• If any of the following vaccinations has been given after a suspected/
known exposure to a potential infectious source, donor shall be
deferred for 1 year from the date of exposure, due to the risk of
exposed infection.
• Anti-rabies (human diploid cell) vaccination
• Rabies Immunoglobulin
• Hep B vaccine
• Hep B immunoglobulin
• Defer for 08 weeks
• Receipt of live attenuated vaccines
• Mumps
• Measles (Rubeola)
• German measles (Rubella)
• Chicken pox (Varicella zoster)
• Typhoid (Oral)
• Polio (Oral)
• Yellow fever
• BCG
• Defer for 01 weeks
• Hep B vaccine
• Defer for 48 hours
• Donors who have received recombinant, killed or inactivated vaccines or toxoids are acceptable after 48 hours if
they are symptom-free and afebrile. These include, but are not limited to, vaccines against,
• Cholera
• Hepatitis A
• Polio (Injection)
• Typhoid (Injection)
• Rabies
• Paratyphoid
• Diphtheria
• Pertussis
• Influenza
• Human papilloma virus
• Tetanus toxoid
Blood transfusion/TPE
• Defer recipient and the current sexual partner of blood and blood
products or plasma-derived coagulation factors for 12 months
following last transfusion
• Defer permanently if on regular treatment with plasma-derived
coagulation factors.
• Prisons and penal institutions
Accept
• After one year from release
 Defer
• Inmates of prisons and penal institutions.
Alcohol intake
• Accept if no signs of intoxication and or smell

Smoking
• Accept
• Defer If on anti-smoking treatments or symptoms related to
treatment
THANK YOU