Blood donors and safety

Sat, Aug 25, 2012, 01:00

Sir, – Your correspondent (David Wilkins, August 24th) raises important points that are fundamental to the delivery of blood safety in Ireland. A recent survey commissioned by Irish Blood Transfusion Service confirmed that the provision of a safe and secure blood supply was the overwhelming requirement of the IBTS. There are many surveys and many statistics, but at present in Ireland and other countries it is 40 times more likely that a man who has sex with another man or men (MSM) will have HIV than a man who does not. The IBTS uses the most sophisticated tests available for the detection of HIV.

Notwithstanding this, there is a period, known as the “window period” where no test will detect the presence of HIV. The IBTS has a duty to protect the recipients of blood from known and, wherever possible, as yet unknown infections. This is one of the reasons why IBTS has not proposed any change to the permanent exclusion of MSM, after very careful review since the decision in England was made to relax the deferral to one year after an episode of MSM activity.

Ireland is not alone, and the US Food Drug Administration is open in its view that it can find no evidence to support a change from lifelong donor deferral. The Netherlands and other EU countries similarly retain this.

Stratifying risk levels at busy donor clinics is difficult, but if there were supporting evidence it might be tried. Unfortunately, monogamy is a difficult state to audit. There is very little evidence on gay couples, but heterosexual married couples have a substantial risk of infidelity over the years, and in most instances the “innocent” party is unaware of his/her partner’s behaviour. For this reason, perceived monogamy is not a factor that can reliably be used to determine acceptance of a blood donor.

Blood supply is not likely to be enhanced significantly by any change, and would not be a reason for such change unless safety was assured.

Nevertheless, IBTS remains grateful for the support it receives from gay, lesbian and transgender organisations in organising its clinics, even though there remains a difference of opinion over this complex area of donor acceptance. – Yours, etc,

Dr IAN FRANKLIN,

Medical Scientific Director,

Irish Blood Transfusion Service,

James’s Street, Dublin 8.