Therapeutic Venesection
Some ARCBS centres provide a therapeutic whole blood venesection service for patients with medical conditions where regular venesection is beneficial.
THERAPEUTIC VENESECTION POLICY
This section describes the principles under which the Australian Red Cross Blood Service will offer a Therapeutic Venesection Programme and the rationale for our recommendations
The Australian Red Cross Blood Service offers a therapeutic venesection service for the benefit of individuals referred by treating clinicians. The final decision as to the suitability and acceptance of individuals to be venesected remains with the Australian Red Cross Blood Service with the following requirements:
1. The therapeutic venesection service is offered to individuals with medical conditions where regular venesection has been shown to be beneficial (e.g. haemachromatosis, polycythaemia (rubra) vera, porphyria cutanea tarda). The individual must not have a transfusion transmissible disease.
Individuals should satisfy the following criteria:
a) have a recognised genetic predisposition to iron overload in the way of homozygosity or compound heterozygosity for the known haemochromatosis genetic mutations
or
b) have biochemical evidence of iron overload (elevated transferrin saturation with or without elevated ferrritin) in the absence of other disease
or
c) are referred by a specialist who has assessed the patient as requiring therapeutic venesection.
2. Individuals with an isolated ferritin only, who do not fulfil the above criteria, would need to be assessed for suitability for routine whole blood donation by an Australian Red Cross Blood Service Medical Officer.
3. The blood collection will be used in clinical or plasma-derived products only if individuals fully meet the donor selection guidelines for clinical use.
4. The referring doctor is ultimately responsible for clinical management and will review the ongoing need for venesection every twelve months or as often as specified by the referring doctor. The Australian Red Cross Blood Service will not be responsible if individuals do not attend for venesection.
5. The Australian Red Cross Blood Service is responsible for therapeutic collection and the care and safety of the individuals during the venesection procedure.
6. Once an individual has been accepted into the therapeutic program, he/she will not be deferred on the basis that the individual’s blood is not suitable for transfusion or the manufacture of plasma-derived products. This is to encourage risk factors to be disclosed in a non-discriminatory process so that the safety of the blood supply is not compromised.
7. Individuals with haemochromatosis who have been suitably ‘de-ironed’ may donate at the same frequency as whole blood donors without the need for the twelve monthly review, subject to the approval of the treating doctor.
8. Individuals aged 71 and over will require an annual medical clearance letter from a doctor to ensure ongoing suitability for venesection.
For further information about the Therapeutic Venesection programme please call the Australian Red Cross Blood Service on 13 14 95 and ask to speak to a Medical Officer.
(updated to website 23 March 2009)