Blood donations from individuals with porphyria cutanea tarda (PCT)

A blood banker colleague in Israel asks what are the medical reasons for deferal of blood donors with Porphyria Cutanea Tarda (PCT)? Are there any blood banks around the world that do accept them for donation? Their policy at MDA Blood Services about PCT patients donating blood is permanent deferral, same as the US Department of Defense (DOD) and NYBC, but following a PCT patient's request for a detailed explanation for the reason why he can not donate blood, they turned to several porphyria experts in Israel and around the world and received different opinions:

Experts in Israel recommend - Donor deferral, since these patients have some unknown metabolic changes and their influence on the transfused patients is yet unknown.
Experts from the European Union opinions were controversial:
- some of them suggested - Donor deferral due to a strong connection to HCV and alcohol abuse (group risk),
- but some of them supported their eligibility to donate, provided they are in remission.

In conclusion, from all the data collected they decided not to change their current policy of not accepting PCT patients as blood donors.

Editors' Note: The porphyrias are a group of diseases in which the synthetic process for the heme molecule is defective. The two main sites in the body for heme synthesis are the bone marrow and the liver. In porphyria cutanea tarda (PCT) there is an enzyme defect within the liver and, in some people, also in the red blood cells, that causes a build-up of porphyrins in the blood and skin. These porphyrins react with light, making the skin fragile and easily blistered. The parts of the skin that are affected are those that are normally exposed to light. Because PCT is non-infectious, one might think it would be safe for a person with PCT to donate blood. In fact, since PCT is associated with excessive amounts of iron stores within the liver, one method of treatment of PCT that can be very effective is the regular withdrawal of blood, in a way similar to giving a blood donation. However, since In PCT there can be a build-up of porphyrins in the blood, it is probably prudent to not use blood collected from an individual with PCT for the transfusion of a sick patient.

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