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Regulation: Blood Donation 4 to 6 months after any natural orifice flexible endoscopy

Updated on: 14 Feb 2020   First published on 14 May 2017

Individuals are unable to donate blood for 4 to 6 months after any natural orifice flexible endoscopy and until they have informed the blood service of the diagnosis.

The reason is twofold, firstly there are certain diagnoses that would either prevent them from donating blood ever again, one being IBD, or prevent them from donating until all investigations and treatment have been completed, and secondly, because there are case reports of patient to patient transmission of viruses such as HBV and HCV linked to GI endoscopy and poor decontamination of endoscopes. These viruses can be successfully inactivated with high-level disinfection but there is always the ‘risk’ that decontamination has not been carried out successfully and we do not on a day to day basis measure the success of each decontamination cycle. There are four Blood Services that take donations and supply blood in the UK. All are required to comply with the Blood Safety & Quality Regulations (BSQR) 2005 which incorporates EU legislation in respect to flexible endoscopy. The Blood Services implement deferrals regarding this depending on their use of discretionary Hepatitis B testing.

In England NHS Blood & Transplant defer donors for 4 months and then test for Hepatitis B core antibody between 4 and 6 months after flexible endoscopy. After 6 months no extra testing is required. NAT testing for Hepatitis B and Hepatitis C is carried out on all donations. The Welsh Blood Service use discretionary testing in a similar way from 120 days after a flexible endoscopy. Currently, the Scottish National Blood Transfusion Service and the Northern Ireland Blood Transfusion Service defer for 6 months and do not use discretionary testing to reduce this deferral.

The Safety of Blood, Tissues & Organs (SaBTO) Committee advises the Department of Health on the most appropriate ways to ensure the safety of blood, cells, tissues and organs for transfusion and transplantation. A SABTO working party is currently reviewing the guidelines regarding flexible endoscopy. However, a recommendation for change would still have to be approved by the EU for a change to be made to the BSQR so a change is unlikely in the near future.

Detailed information on how health and travel may affect their eligibility to donate is available for donors

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