I have Pernicious Anaemia. Can I donate blood?
People with Pernicious Anaemia (PA) can donate blood in the UK once they are on maintenance treatment and they are well. You may be wondering what exactly is meant by maintenance treatment and being well, or are you concerned about how donating could affect your health, or whether your blood is good for patients? Below we will try to answer these questions.
Your health as a blood donor
Red blood cells carry oxygen around the body. In PA a shortage of vitamin B12 affects the size and shape of red blood cells which reduces their ability to carry oxygen. This causes symptoms such as tiredness and shortness of breath.
However, when Pernicious Anaemia is successfully treated and patients feel well again then that is a sign that the red blood cells are back to working effectively. Then the person is well enough to become a blood donor. Ongoing treatment to prevent anaemia happening again is OK according to the guidelines1 used by the UK blood services. These guidelines are in place to protect the health and safety of donors as well as patients. We would not want anyone to donate whilst they were not feeling well and dealing with anaemia and problems with their red blood cells and oxygen transport around the body. We would almost certainly make symptoms worse and risk causing more serious health issues by taking blood from them at that time.
The low B12 level can be due to a number of causes, all related to disruption of the absorption of B12 in the intestine. This requires Intrinsic Factor (IF), a substance secreted by the lining of the stomach. Surgery to remove all or part of the stomach or anything that affects the lining of the stomach can lower the amount of IF. But more commonly the level of IF is normal
but it is stopped from working because it is blocked by IF antibodies.
IF antibodies are produced by the body as an autoimmune response (an attack against your own body). People with PA may also have other autoantibodies causing conditions such as diabetes and thyroid disease.
Antibodies including autoantibodies are contained within the plasma (liquid part) of blood but there aren’t any reports of IF antibodies causing problems or development of the associated conditions in patients who have received transfusions from donors with PA. The blood we collect from donors is separated into red cells, plasma and platelets (blood cells that stop bleeding and bruising). Red cells and platelets only contain a very small residual amount of plasma that means transfused patients will not receive enough IF antibodies to cause problems. Even with plasma products, the amount of IF antibodies transfused into the body’s circulation does not appear to cause any significant problems with B12 depletion in the patient. If there was any evidence that there was even the smallest risk of patient harm from IF antibodies then our guidelines1 would be updated to reflect this. Based on this as long as the underlying cause for PA and any associated conditions do not exclude donation then it is ok to become a blood donor.
For more information about blood donation and becoming a blood donor please see the information provided by your national blood service.
England: https://www.blood.co.uk/
Scotland: https://www.scotblood.co.uk/
Wales: https://www.welsh-blood.org.uk/
Northern Ireland: https://nibts.hscni.net/
Reference
Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee Donor Selection Guidelines https://www.transfusionguidelines.org/dsg/wb
With grateful thanks to Jill Clark and Dr Angus Wells for this very informative article. Dr Wells is the Chair and Jill Clark a member of the Standing Advisory Committee for the Care and Selection of Donors (SAC-CSD) that is part of the structure of JPAC and provides professional advice to JPAC about the Donor Selection Guidelines referenced in the article. Both work for the Donor Medical Team
within NHS Blood and Transplant.