A transfusion medicine physician in Ohio comments that the National Marrow Donor Program (NMDP) requires individuals with autoimmune disease to be excluded from donation of hematopoietic stem cells and bone marrow. She believes that microchimerism may play a role in the development of autoimmune disease in some patients, so that autoimmunity may be transmissible by hematopoietic stem cell and bone marrow transplantation. One reference to the aforementioned deferral requirement can be found on page 27 of the NMDP donor center procedure "PBSC for Primary Transplantation", Version 8.0, which states "History of autoimmune disorders, including rheumatic diseases and thyroid disorders. Exception: As with bone marrow donations, donors with a history of autoimmune thyroid disease who have undergone medical or surgical thyroid ablation may be eligible. Approval must be obtained from the NMDP." A second reference to the aforementioned deferral requirement can be found in the "NMDP Health History Questionnaire Rationale" version 5.0, p. 9, which states "Donors with a history of autoimmune disease shall be deferred from donation. Administration of filgrastim to donors with autoimmune disease may experience advancement of the disease (sic). In addition, autoimmune disease may be transferred from the donor to the recipient via stem cell transplantation." Since hematopoietic stem cells and bone marrow can be considered a form of blood product, the Ohio physician wonders if potential blood donors should also be excluded from blood donation if they have autoimmune disease.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator