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Accept n Individuals with G6PD deficiency or other inherited red cell membrane defects, without a history of haemolysis; however, their blood is not suitable for intrauterine transfusion, neonatal exchange transfusion or for patients with G6PD deficiency Defer permanently n Individuals with G6PD deficiency or inherited red cell membrane defects, with a history of haemolysis 5.1.4 Thrombocytopenia Individuals with thrombocytopenia should not be accepted as blood donors because of the risk of bleeding at the venepuncture site and because chronic thrombocytopenia may be associated with serious underlying haematological or other systemic disease. A past history of autoimmune thrombocytopenia is not a contraindication to blood donation, even if treated by splenectomy, provided that the prospective donor has been well for five years with no evidence of relapse (64). Recommendations Accept n Individuals with a past history of acute autoimmune thrombocytopenia more than 5 years previously, provided they are well and no longer require treatment, other than prophylactic antibiotics following splenectomy Defer permanently n Individuals with thrombocytopenia of unknown cause or associated with longterm haematological or systemic disease 5.1.5 Secondary erythrocytosis Donors with secondary erythrocytosis due to smoking may be accepted provided that polycythaemia rubra vera has been excluded and other donor selection criteria are fulfilled. Recommendation Accept n Individuals with secondary erythrocytosis, provided that a diagnosis of polycythaemia rubra vera is excluded 52 5.1.6 Hereditary haemochromatosis This inherited condition of iron overload through excessive iron absorption of dietary iron can be treated by phlebotomy; individuals who are otherwise healthy and meet all other donor selection criteria may be accepted as blood donors (119) and indeed bled more frequently before donation-induced iron deficiency supervenes (67). However, special arrangements are needed if the maintenance therapy requires reduction of the inter-donation interval (120,121). Recommendation Accept n Individuals with hereditary haemochromatosis who fulfil all other donor selection criteria 5.1.7 Coagulation disorders, including haemophilia A and B These disorders are usually due to inherited deficiency of coagulation factors. Patients with such disorders are not acceptable as blood donors because of the risk of excessive bruising at venepuncture sites and because treatment is usually with blood products. Known carriers of coagulation disorders may be accepted provided they have normal or near normal coagulation factor levels and no bleeding or bruising tendency. Acquired coagulation disorders are rare and usually associated with serious underlying disease. Recommendations Accept n Individuals with carrier states for inherited coagulation disorders including haemophilia A or B, provided they have normal or near normal coagulation factor levels, do not have a history of abnormal bleeding and have not received treatment with blood products Defer permanently n Individuals with coagulation factor deficiencies, whether inherited or acquired 5.2 CARDIOVASCULAR DISEASES Assessment of the suitability of individuals with cardiovascular disease should be based on the effect of the condition on the individual‘s ability to tolerate haemodynamic changes due to blood donation.