This document provides guidance for the selection of unrelated allogeneic bone marrow and peripheral blood stem cell donors. It must be read in conjunction with Chapter 22 (haemopoietic progenitor cells) of the Guidelines for the Blood Transfusion Services in the United Kingdom - 8th Edition, 2013, which lists the general, and some specific aspects of donor selection.
Donors are selected firstly to ensure that they do not come to harm from giving their donation and secondly to ensure that their donation is unlikely to harm any recipient. The ultimate responsibility for the selection of donors rests with the respective National Medical Director.
The immediate responsibility is with the Qualified Healthcare Professional who must ensure that the donor fulfils the respective selection guidelines. When it is not clear if an individual donor is acceptable, the donation should not be collected without discussion with a Designated Medical Officer. It is recognized that a particular donation of bone marrow or peripheral blood stem cells may be potentially uniquely life saving. It is important that when a Designated Medical Officer makes a concession outside of these guidelines, that this is discussed with the medical team of the recipient and the reasoning for the concession documented.
The prospective donor must be evaluated for their suitability to donate by a Qualified Healthcare Professional who has undergone appropriate training to use this document. They must verify their assessment by signing and dating the donation record.
Special note must be taken of the content of the Tissues Safety Entry in the A-Z.
It is the responsibility of the Qualified Healthcare Professional to ensure that the donor clearly understands the nature of the donation process. They must also understand the health questions and other information presented to them. The donor is asked about confidential aspects of their medical history, hence great care must be taken over privacy and confidentiality. This means that third party interpreters can only be used, as described in the A-Z entry on Communication Difficulties.
Where there is separate guidance for Bone Marrow and for Peripheral Blood Stem Cell donors, this is made clear.
When there is a recognized risk to either the donor or the recipient, the guidelines must be followed.
The following terms may be used:
Lists any other terms which may be covered by the Guideline.
Where additional clarity is required, a definition is provided.
This will indicate how the donor must be dealt with by the use of several terms:
Must not donate
The donor must not donate if any of the statements apply to them, unless a 'discretion' clearly applies. Often the exclusion will depend on time related factors. If a donation cannot be taken, the donor must be clearly advised why.
Refer to Designated Medical Officer
Is used when there is a need to seek further advice. The Designated Medical Officer is a suitably trained person authorized to undertake this task by the National Medical Director.
Gives reasons why a donor may be permitted to donate. The statements are conditional. All statements that must be fulfilled come before the final statement that they may be accepted. If the donor fulfils these requirements, as well as all others that apply, then they can be accepted.
See if relevant
Is used when an A-Z entry may or may not need to be consulted. This will depend upon the information provided by the donor.
This provides background information as to why a particular action or actions is required.
Means that the specified A-Z entry must be consulted.
Reason for Change
This indicates the background to any changes made to the entry since the last Edition or Release.
Some or all of these terms may be used under each subject heading or sub-heading.
This section was last updated in TDSG-BM Edition 203, Release 02.