JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

Weight

Obligatory

1. Bone Marrow Donor:
Must not donate if:

a) Body Mass Index over 35.

b) Under 50 kg (7 stone 12 lbs.).

c) Obtain anaesthetic opinion if:
Body Mass Index between 30 and 35.

2. PBSC Donor:
Must not donate if:

a) Body Mass Index over 40.

b) Under 50Kg (7 stone 12 lbs).

c) The donor is so overweight that they have difficulty in getting onto or off the bleed bed.

d) Venous access is very difficult.

Discretionary

a) Potential PBSC donors with a BMI between 35 and 40 should be carefully assessed for other risk factors for cardiovascular disease before they are
accepted as suitable.

b) Treatment with anti-obesity drugs, accept.

Additional Information

Blood service staff should not put their own health at risk by helping donors on and off the donation couch except in an emergency.

It is recommended that no donor should lose more than 13% of their blood volume during any donation procedure. This is to protect them from adverse
effects such as fainting and becoming anaemic. There is a minimum donor weight at which a donation can be accepted. This is not always appropriate.

Obesity also makes it desirable to use more than a donor's weight to estimate their blood volume. Fat contains far less blood as a proportion of its weight
than muscle. In obese individuals the blood volume can be seriously overestimated from weight alone. Overestimating a donor's blood volume
makes it more likely that they will have an adverse incident.

Donors who are overweight or obese tend to have more moderate-severe pain with PBSC donation. BM harvest is technically a considerably more difficult
procedure in overweight donors. There is much evidence to support the concept that the morbidly obese in general (i.e., with a BMI >35) have a higher
risk of premature death, anesthetic complications and occult cardiovascular disease.

Reason for Change

The levels of BMI/weight at which a PBSC donor can be accepted have been changed to align with Anthony Nolan, DKMS, NMDP and Canadian current guidance and WMDA draft guidance.

Update Information

This entry was last updated in
TDSG-BM Edition 203, Release 17