Dear José Antonio

GENERAL GUIDELINES


To give blood for transfusion to another person, you must be healthy, be at least 17 years old, weigh at least 110 pounds, and not have donated blood in the last 56 days. "Healthy" means that you feel well and can perform normal activities. If you have a chronic condition such as diabetes or high blood pressure, "healthy" also means that you are being treated and the condition is under control. 
Other aspects of each potential donor's health history are discussed as part of the donation process before any blood is collected. Each donor receives a brief examination during which temperature, pulse, blood pressure and blood count (hemoglobin or hematocrit) are measured. 
Making donations for your own use during surgery (autologous blood donation) is considered a medical procedure and the rules for eligibility are less strict than for regular volunteer donations. 




Blood Pressure, High


Acceptable as long as your blood pressure is below 180 systolic (first number) and below 100 diastolic (second number) at the time of donation. Medications for high blood pressure do not disqualify you from donating. 


Blood Pressure, Low


Acceptable as long as you feel well when you come to donate. If your blood pressure normally runs low, it may be more difficult for your body to adjust to the volume loss following donation, especially if you are dehydrated. Drinking extra water before and after donation is important

source: www.patient.co.uk

Our centre in Accra performs Normovolaemic Haemodilution for some of our cardiac patients who have good starting haemoglobins. For patients with some diseases such as hypertension, diabetes we will still do the NHD so long as the patients are well controlled without any evidence of postural hypotension and significant end-organ damage. We have done this especially in Jehovahs' Witnesses with good results

Ernest Aniteye

Dear José,

In Germany, we allow donors to donate allogeneic whole blood up to a BP of 180/100 mm of mercury. A hypertensive donor is allowed to donate as long as his/her BP is below this margin. We do not produce therapeutic plasma out of such a whole blood donation, if the donor takes standard antihypertensive medication. We try to avoid a donation within 6 hrs from taking the meds. Since most meds are either taken in the morning or late in the evening, this does not affect us very much.

Since each donor is seen by a physician before each donation, we look especially for organ damage in the history (e.g. angina, signs of perfusion deficits in the cerebral, cardiac or renal system, heart insufficiency, etc.). The latter "patents" are excluded from donation.

If a donor takes a combination of antihypertonics, it is a decision by the donor doctor seeing the donor before the donation, when he sees a problem. In our expereince, donors start with a single drug or a combination of two. If this is insufficient, such donors often have additional cardiovascular Problems, which exclude this Person from further donations.

Hope, this is helpful to answer your question.

Best wishes,

Markus

Given that under emergency situations blood from a normal healthy donor is not available, blood drawn from a person with high blood pressure may be acceptable for transfusion after due cross-matching. As a matter of fact for severe hypertensives earlier treatment used to be blood letting as a therapeutic approach to lower the blood pressure. As a general practice blood should not be drawn too fast for fear of hypotension.

Obviously. We'll see if there's any specific regulations in your country. Otherwise, you can donate blood if the voltage is mastered and remains below 18/10. In all cases, special care must be provided to the donor that may develop hypotension after the gift and the recipient also.

Obviously. We'll see if there's any specific regulations in your country. Otherwise, you can donate blood if the voltage is mastered and remains below 18/10. In all cases, special care must be provided to the donor that may develop hypotension after the gift and the recipient also.

Dear all

Thanks to everybody

Nice debate!

Great experience from three continent

My question was about non autologous blood donors!

In Spain, like in most european countries, we accept hypertension patients in autologous donation (predeposit or hemodilution). But, actually autologous blood donation is decreasing very fast.

Dear Markus

At Spain, historically in most of blood centers we considered HTA patients under treatment as "unsane". We considered, like Nelson eplains marvelous, blood donor must be "healthy" and "unprofit". It was during years cause of exclusion.

Since 2005, by law, "severe HTA" is a definitive exclusion cause. But, during last years, since 2006 (after EPO black worning alert) in Spain the blood consume has increased (red cell transfusion grows almost 20% in only 5 years). Unfortunely, the new donor figure does not increased. Probably, after this consume "crisis", most of Regional Blood Centers beging to accept HTA patients (also under two drugs treatment). Of course, they must have normal level (TA

In the United States the Food and Drug Administration (FDA) lists the following qualification for a blood donor concerning blood pressure: 21CFR640.3(b)(2) "Demonstration that systolic and diastolic blood pressures are within normal limits, unless the examining physician is satisfied that an individual with blood pressures outside these limits is an otherwise qualified donor under the provisions of this section;" Most blood centers will define normal limits as: systolic blood pressure between 90-180 mm Hg and diastolic blood pressure between 50-100 mm Hg. I hope this is useful information.

There is not a lot of science behind the US FDA requirement for a "normal" blood pressure to be a blood donor. This was discussed extensively at a 2009 FDA Blood products advisory meeting.: http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/BloodVaccinesandOtherBiologics/BloodProductsAdvisoryCommittee/UCM189018.pdf

This document elegantly details the prior research in the area noting conflicting data in generally very old studies, but if anything high blood pressure appears to convey some protection against fainting!

Nonetheless, in the US we are contrained by the code of federal regulations definitions of high or low blood pressure and can only draw donors in the "normal" range.

There is not a lot of science behind restrictions requiring a normal blood pressure for blood donors. There was a very elegant discussion of this issue at a 2009 blood products advisory meeting, a group that advises the US FDA

http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/BloodVaccinesandOtherBiologics/BloodProductsAdvisoryCommittee/UCM189018.pdf

this document discusses in detail the older studies that are at best conflicting and some even show a protective effect of high blood pressure against the side effect of fainting.

This is the general roles in Sweden. If you have had stable blood pressure (normalized

, no specific levels are specified) and had the same medication and dose for at least 4 weeks, you can give blood, local discrepancies may occur.

Talking about evidence, does this answer the question?

Http://www.ncbi.nlm.nih.gov/pubmed/19878496

I agree with Bjorn, unless there is any other medical reason then Hypertension should not preclude anyone from being an allogenic donor.

As per my knowledge, there is no harm in donation of allogenic blood by hypertensive patients as far as the blood pressure of the individual is below 180/100 at the time of donation. Even if he has had medication for hypertension, he is still eligible for the donation.

No

Thanks everybody

After 48 hours hours of debate, actually there are more questions open!

First) Is it a patient diagnosed of HTA and under especific treatment sane or unsane? If he is unsane or unhealthy, can be allogenic donors?

At EEUU yes, but at some european countries Not!

Second) Which are the normal or safe, minimun or maximun, levels of HTA to donate? There is no clear evidence. Most of them are simple expert oppinions

Third) Is it dangerous donate blood with elevated or decreased arterial Tension level? Probably it is no dangerous donate high or low levels, if those are the normal patient´s level. Also, probably, blood donation could be benefit to same HTA patients.

Four) What happens with the residual drug levels still present in the blood components? Must we have some concern?

Thanks again

it is important why donor with HTV wants to be donor? are they first time donor or they are regular donor and what is the blood pleasurev?are they use drag regular ?what drug are theu use? of course your making packed cell ?are you useing the plasma

for fractiontion or your strategy is useing FFP ?what is your countery stretegy ?it bis not absoulatley reject donor i thing it is important you know the ansarw of all qusetion and then act .it may be if you reject all without good evidence it may be happended shortage in your region and of course one more that is it ethic for your donor and what will be come with the people motivation?

Thanks

yes provided the Blood pressure is controlled between: Systolic: Below 160 mm Hg & Diastolic below 100 mm Hg and of course Stable Cardiac status If the donor is donating blood regularly this holds good for age till 60 years, but if the donor is donating first time this hold good if the age is less than 55 years.

Thanks

At Europe, we ussualy do not accept new donors older than 60, but veterans can continue donating after 65 y/o till 70.

They are not oldies now, only mature!