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# Autoimmune disease - Whole blood and components

## Essential information

Obligatory

  See: is there a specific entry for the condition you are assessing?

  Must not donate if:

  1. The donor has needed treatment with steroids or conventional disease modifying antirheumatic drugs to suppress the condition in the last 12 months.
  2. The donor has needed treatment with monoclonal antibody therapy or other biologic disease modifying antirheumatic drugs to suppress the condition in the last 6 months.
  3. The cardiovascular system is involved.
  4. The donor has ongoing lung disease or renal impairment due to their condition.
Discretionary
  1. If the donor:
     1. Has been established on a stable maintenance treatment for an autoimmune disease with only one of the following drugs:
        1. Methotrexate
        2. Sulfasalazine
        3. Hydroxychloroquine
        4. Azathioprine, and
     2. The dose of the drug has not increased in the previous 6 months, and
     3. The donor is well, accept.
  2. If there is any uncertainty about the diagnosis or the nature of treatment, refer to a Designated Clinical Support Officer.

## Supporting information

See if relevant
  - Cardiovascular disease
  - Disabled donor
  - Drugs and platelet donation (drug index)
  - Fertility
  - Inflammatory bowel disease
  - Liver disease
  - Monoclonal antibody therapy and other biological modalities
  - Nonsteroidal anti-inflammatory drugs
  - Skin disease
  - Steroid therapy
  - Thrombosis and thrombophilia

  If treated with transfusion, immunoglobulin, plasma exchange or filtration:

  - Transfusion
Additional information

  Conventional systemic Disease Modifying Antirheumatic drugs (csDMARDS) are viewed as disease-modifying drugs. They include methotrexate, sulfasalazine, hydroxychloroquine and azathioprine. Sulfasalazine and hydroxychloroquine have limited effect on the immune system. If used for maintenance treatment, methotrexate and azathioprine are usually given at lower doses which do not cause a significant degree of immunosuppression.

  If the donor is taking higher dose methotrexate or azathioprine, they should not be accepted. If there is uncertainty about the dose refer to the Designated Clinical Support Officer for assessment. Further information on these drugs and immunosuppression can be found in the Green Book: Immunisation against infectious disease.

  Nonsteroidal anti-inflammatory drugs do not suppress the donor's immune system.

  Physical therapies such as physiotherapy and hydrotherapy are not considered treatments to suppress the condition.

  Autoimmune disease can cause problems such as infertility and thrombosis (antiphospholipid or Hughes syndrome).

  Some autoimmune conditions can permanently damage the cardiovascular system. If this is known to have happened, the person should not donate as they are more likely to have a serious adverse event.

Reason for change:
  The obligatory criteria have been expanded to specify the deferral period required depending on the type of treatment.
Version details:

  WB-DSG Edition 203 Release 74 (26 November 2024)

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