European Committee on Blood Transfusion (CD-P-TS)
Deferral criteria for blood donors, especially with regard to sexual behaviours, are much debated. The present situation involving the permanent deferral of individuals whose behaviour places them at high risk of acquiring severe infectious diseases that are transmissible by blood is being questioned in terms of whether this kind of donor deferral is rightful, appropriate, efficient and required.
Despite the testing of blood donations with highly sensitive test systems, there remains a residual risk of transfusion-transmitted infection due to donations given in the 'window' period, i.e. the time period between infection and detectability of the infection; a fact that is not always recognised by the public.
As a consequence, the CD-P-TS of the EDQM, Council of Europe, appointed a working group (TS057) to monitor current practices, evaluate scientific data and define a harmonised approach for donor deferral, linked to the risks attributable to sexual behaviour (1). The group started its work in February 2010 and completed a review of the collected data by the end of 2011.
The working group performed a European-wide evaluation of donor selection criteria according to technical memorandum outlining the results of the study was completed and published on the project website in April 2012.
The findings of the working group re-emphasise that adherence to donor deferral rules is crucial for blood safety. Standardised donor questionnaires and donor education are needed to increase adherence to deferral rules. Also, standardised collection of data throughout Europe needs to be performed to monitor epidemiology and adherence since, at present, the available data do not allow a general decision to move away from the donor deferral rules currently being applied in relation to sexual behaviours.
A proposal for a Resolution with further recommendations for such data collection was submitted to the Committee of Ministers of the Council of Europe. On 27 March 2013, Resolution CM/Res(2013)3 on sexual behaviours of blood donors that have an impact on transfusion safety was adopted.
Recommendation No. 5 of Resolution CM/Res(2013)3 calls for standardised, on-going data collection on the incidence and prevalence of sexually-transmitted infections in the general population, in blood donors and among individuals with risky sexual behaviours for use as a scientific basis for amendments to donor deferral policy. The CD-P-TS will initiate a project to provide member states with guidance on data collection. It is anticipated that this project will allow donor deferral criteria to be defined based on recognised risks linked to sexual behaviours and their relevance to blood safety, irrespective of the sexual orientation of the blood donor.