Bleeding Disorder: Difference between revisions

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QUALIFIED
QUALIFIED


==Acceptability at CT / Work-Up==
==Acceptability at VT / Work-Up==
QUALIFIED
QUALIFIED


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==Explanation of Condition==
==Explanation of Condition==
Most haemophilias are inherited disorders of blood clotting. They may be of varying severity, but generally prohibit bone marrow donation.
Haemophilias are a rare group of mostly inherited/genetic disorders that prevents blood from clotting normally due to a lack of specific blood-clotting proteins (clotting factors). They may be of varying severity, but generally prohibit bone marrow donation. Individuals can have the disease or be a carrier (also known as trait). There are also some haemophilias that are acquired during life, and may be transient.


Some haemophilias are acquired during life, and may be transient.
 
Some deficiencies cause significant bleeding, either spontaneously or in response to even minimal trauma or minor procedures. Individuals will have been assessed and advised about their condition and bleeding risk. They may have received treatment or been told in the future they would need prophylactic treatment for surgery, dental treatments or any other procedures.


==Guidance==
==Guidance==
Discuss with medical officer.
'''At Recruitment'''


<b> For known history: </b>
UNACCEPTABLE - Diagnosis of haemophilia A (Factor VIII deficiency), haemophilia B (Factor IX deficiency), type 2 von Willebrand disease, type 3 von Willebrand disease.


Unacceptable if history of excessive spontaneous or provoked bleeding, or laboratory demonstrated severe or moderate haemophilia (including asymptomatic factor XI deficiency).  
QUALIFIED - Carriers may join the register if:
# Have never had any excessive bleeding or bruising, and 
# Have never received any treatment to reduce or prevent excessive bleeding, and 
# Is not requiring monitoring or follow-up, accept.  


Female carriers of haemophilia A and B should be discussed with medical officer. Consider for PBSC only if bleeding risk thought to be negligeable and after liaison with haemophilia centre.


Not for central venous catheter insertion or bone marrow harvest.
'''At CT / Work-up '''


Any degree of factor XII deficiency is acceptable as long as there is no history of thrombosis.
Discuss with medical officer.




<b> For newly identified clotting abnormalities at medical: </b>
<b> For known history: </b>


Assess the donor for personal and family history of excessive bleeding and bruising.
Establish what type of bleeding disorder or specific coagulation factor deficiency donor has (or is a carrier of).  


• Has the donor noticed any excessive bleeding – e.g. after injuries or cuts?
Must not donate if diagnosed with haemophilia A (Factor VIII deficiency), haemophilia B (Factor IX deficiency), asymptomatic factor XI deficiency


• Has the donor noticed any excessive bleeding – e.g. after injuries or cuts?
3 types of von Willebrand disease: only donors with type 1 are potentially eligible, Type 2 and 3 are more severe and unacceptable.


• Does the donor experience heavy periods?
Any degree of factor XII deficiency is acceptable as long as there is no history of thrombosis.


• Any issues with bleeding that was difficult to stop following an operation or tooth extraction?


• Does the donor experience nosebleeds? If so, how often do they happen, are the nosebleeds from one nostril or both, how long do they take to stop and what measures are needed for the nosebleeds to stop?
Carriers should be discussed with medical officer. They can be considered for PBSC if they fulfil following criteria:
* Has not received a transfusion since 1 January 1980, and
* Has never received any type of coagulation factor treatment, and
* Has never received any other treatment to reduce or prevent excessive bleeding, and
* Has not received or been advised that they will require prophylactic treatment, and
* Has never had any excessive bleeding or bruising, and  
* Is not requiring monitoring or follow-up, and
* The underlying cause and/or treatment does not preclude donation, accept.


• Has the donor ever experienced significant joint swelling? (i.e. potentially bleeding into their joints).


• Has the donor noticed any easy bruising?
<b> For newly identified clotting abnormalities at medical: </b>
 
• Has the donor had any blood clots in the past?
 
• Are there any family members with bleeding disorders, or abnormal bleeding or bruising?


• Are there any family members who have had blood clots?
Assess the donor for personal and family history of excessive bleeding and bruising:


*Do you have any bleeding symptoms such as frequent nose bleeds, bleeding from the back passage or bleeding from the gums?
*Have you ever consulted a doctor or received treatment for prolonged or unusual bleeding e.g. with nosebleeds or minor wounds?
*Do you experience bruises/haematomas larger than 2cm without trauma, or severe bruising after minor trauma?
*Have you ever had surgery (major or minor) or any dental procedures? If yes - Have you ever experienced or been told you had prolonged or excessive bleeding after or during these procedures or required medical attention for this?
*Is there anyone in your family who suffers from a bleeding disorder e.g. Haemophilia/Von Willebrand disease?
If assigned female at birth:
*Have you ever consulted a doctor or received treatment for heavy or prolonged menstrual periods (contraceptive pill, iron etc.)?
*Have you given birth - If yes - Did you experience prolonged or excessive bleeding after delivery?


If the history is reassuring, repeat the coagulation screen with relevant factor levels as spurious results can occur.


If the history is reassuring, repeat the coagulation screen as spurious results can occur.
If APTT remains prolonged in isolation but factor levels are normal (> 0.5) and there is no bleeding history - the donor can be cleared if the CC are in agreement. If there are concerns from the CC or regarding bleeding history discuss case with a clotting specialist.
 
Abnormalities should be discussed on an individual basis.


==Pseudonyms or Related Conditions==
==Pseudonyms or Related Conditions==
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Platelet Disorder
Platelet Disorder
==Version==
==Version==
Version 1, Edition 1
Version 2, Edition 2


====Date of Last Update====
====Date of Last Update====
15th June 2012
24th June 2026
 
29th October 2029

Latest revision as of 18:10, 29 October 2026

Acceptability at Recruitment

QUALIFIED

Acceptability at VT / Work-Up

QUALIFIED

Individual at Risk

Donor

Explanation of Condition

Haemophilias are a rare group of mostly inherited/genetic disorders that prevents blood from clotting normally due to a lack of specific blood-clotting proteins (clotting factors). They may be of varying severity, but generally prohibit bone marrow donation. Individuals can have the disease or be a carrier (also known as trait). There are also some haemophilias that are acquired during life, and may be transient.


Some deficiencies cause significant bleeding, either spontaneously or in response to even minimal trauma or minor procedures. Individuals will have been assessed and advised about their condition and bleeding risk. They may have received treatment or been told in the future they would need prophylactic treatment for surgery, dental treatments or any other procedures.

Guidance

At Recruitment

UNACCEPTABLE - Diagnosis of haemophilia A (Factor VIII deficiency), haemophilia B (Factor IX deficiency), type 2 von Willebrand disease, type 3 von Willebrand disease.

QUALIFIED - Carriers may join the register if:

  1. Have never had any excessive bleeding or bruising, and
  2. Have never received any treatment to reduce or prevent excessive bleeding, and
  3. Is not requiring monitoring or follow-up, accept.


At CT / Work-up

Discuss with medical officer.


For known history:

Establish what type of bleeding disorder or specific coagulation factor deficiency donor has (or is a carrier of).

Must not donate if diagnosed with haemophilia A (Factor VIII deficiency), haemophilia B (Factor IX deficiency), asymptomatic factor XI deficiency

3 types of von Willebrand disease: only donors with type 1 are potentially eligible, Type 2 and 3 are more severe and unacceptable.

Any degree of factor XII deficiency is acceptable as long as there is no history of thrombosis.


Carriers should be discussed with medical officer. They can be considered for PBSC if they fulfil following criteria:

  • Has not received a transfusion since 1 January 1980, and
  • Has never received any type of coagulation factor treatment, and
  • Has never received any other treatment to reduce or prevent excessive bleeding, and
  • Has not received or been advised that they will require prophylactic treatment, and
  • Has never had any excessive bleeding or bruising, and
  • Is not requiring monitoring or follow-up, and
  • The underlying cause and/or treatment does not preclude donation, accept.


For newly identified clotting abnormalities at medical:

Assess the donor for personal and family history of excessive bleeding and bruising:

  • Do you have any bleeding symptoms such as frequent nose bleeds, bleeding from the back passage or bleeding from the gums?
  • Have you ever consulted a doctor or received treatment for prolonged or unusual bleeding e.g. with nosebleeds or minor wounds?
  • Do you experience bruises/haematomas larger than 2cm without trauma, or severe bruising after minor trauma?
  • Have you ever had surgery (major or minor) or any dental procedures? If yes - Have you ever experienced or been told you had prolonged or excessive bleeding after or during these procedures or required medical attention for this?
  • Is there anyone in your family who suffers from a bleeding disorder e.g. Haemophilia/Von Willebrand disease?

If assigned female at birth:

  • Have you ever consulted a doctor or received treatment for heavy or prolonged menstrual periods (contraceptive pill, iron etc.)?
  • Have you given birth - If yes - Did you experience prolonged or excessive bleeding after delivery?

If the history is reassuring, repeat the coagulation screen with relevant factor levels as spurious results can occur.

If APTT remains prolonged in isolation but factor levels are normal (> 0.5) and there is no bleeding history - the donor can be cleared if the CC are in agreement. If there are concerns from the CC or regarding bleeding history discuss case with a clotting specialist.

Pseudonyms or Related Conditions

Haemophilia A

Haemophilia B

Factor XIII, XI, VIII, VII or V Deficiency

Hypofibrinogenaemia

Dysfibrinogenaemia

Von Willebrand Disease

Platelet Function Defect

Platelet Disorder

Version

Version 2, Edition 2

Date of Last Update

24th June 2026

29th October 2029