Heroin addicts and other intravenous drug users, previously banned from donating blood, can now do so, after the Western Cape Blood Service eased restrictions on who can give blood and when in a bid to boost its blood stocks.
Users of intravenous recreational drugs will not be able to donate blood, however, if they have shot up within the past three months, says the blood bank.
Other changes include reducing the deferral periods after dental procedures; allowing insulin-dependent diabetic blood donors to donate blood – provided their blood-sugar levels are under control; and donors who underwent cosmetic procedures such as Botox, micro-needling, and laser therapy can now donate immediately after these procedures – provided the treatment was performed by a registered practitioner using disposable needles.
Stricter deferrals have, however, been put in place for those who have had strokes or transient ischaemic attacks (mini-strokes).
The blood service’s lead medical consultant, Dr Caroline Hilton, said the changes had been carefully reviewed and compared to national and international policies. She assured the public that the safety of both the patient and donor would always remain their utmost priority.
A deferral is a waiting period applied when a donor does not qualify to donate within the specified time due to various reasons, including certain activities or illnesses.
“In addition, people with pacemakers can also donate blood. However, a confirmation letter is needed from their doctor stating that they are asymptomatic and the device was inserted more than six months before the day of donation,” said Dr Hilton.
Donors who have had a cardiac bypass or stent can donate six months after the procedure without the previous requirement of a letter from their doctor, provided they are asymptomatic.
As for the changes to the blood service’s policies regarding intravenous drug users, Dr Hilton said the deferral period started three months after they last used intravenous drugs. People using intravenous recreational drugs were previously permanently deferred.
“Due to improved confidence in the testing methodologies used to detect specific viral infections in blood donations, they can now donate after a three-month deferral.”
The main concern was not transmission of the drug from the donor to the patient but the risk of transmission of infection through sharing needles with other users (a common infection transmitted through needle-sharing is hepatitis C, for example).
“While the drug metabolites may persist, the narcotic substance would not last longer than several days. We are completely reliant on the honesty of our donors when they complete their pre-donation questionnaire. We try to educate our donors about the reasons behind the deferrals to remind them that there is someone at the end of the line receiving their product who could be harmed,” said Dr Hilton.
People who donate blood are required to complete a detailed questionnaire to spot any high-risk behaviour that might compromise the safety of their blood and harm the recipient. Donors are also interviewed by a nursing sister to make sure they have understood the questions, Dr Hilton said.
Blood services in South Africa test every donation for HIV, hepatitis B, hepatitis C and syphilis.
“We currently use state-of-the-art laboratory testing (called ‘nucleic acid testing’) so are confident that the infections we test for would be detected within a three-month deferral from the donor’s last exposure. If a person is found to be positive for any of the infections we test for, they are notified in order to seek medical attention, their blood is discarded and they are prevented from donating in the future,” said Dr Hilton.
Dr Hilton said the service hoped the changes would result in fewer people being turned away from donating blood.