A Transfusion Medicine Service Medical Director in Missouri recently saw a woman who at the time of an attempted blood donation had a history of miscarriage more than 6 weeks previously. The donor center routinely defers women for at least 6 weeks after they have been pregnant. However, since they do not routinely ask recently pregnant women whether they received RHIG immunoprophylaxis in association with a pregnancy, they did not learn about this until later. At this time concern was raised about the need to defer the woman more than 6 weeks, since RHIG (anti-D immune globulin) is derived from human blood, and the donor center defers prospective donors for a year after receipt of a blood product transfusion. The Missouri physician wonders what others would do in this situation (defer or not defer the donor based on her having receiving RHIG), and upon what published data such a decision would be based.

The following comments have been received.

ADDENDA Dec. 10, 2004

1. A transfusion medicine physician, affiliated with a multi-state network of regional blood centers, reports that based on her reading of the FDA memorandum (pdf file) of April 23, 1992, it is not necessary to defer a prospective blood donor for exposure to RhIg. According to that FDA memo, persons who have received a transfusion of whole blood, a blood component (e.g. cryoprecipitated AHF, platelets) or a clotting factor concentrate (e.g., Factor IX, Human) are to be deferred for 12 months; however, receipt of an FDA-licensed plasma derivative other than a clotting,factor concentrate (e.g., Albumin, Human) is not a basis for exclusion.

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