Can Ostomates Donate Blood?

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Can Ostomates Donate Blood? (Updated)

Note: This is an updated version of an article I originally wrote for our August 2006 newsletter. I’m including this because I’ve noticed that some of the newsletters from other ostomy groups have been, once again, printing the “horror story” referenced in my first paragraph below.

Ostomy newsletters sometimes publish warnings that ostomates, especially ileostomates, shouldn’t donate blood. An often cited horror story concerns an ileostomate who, after giving blood, developed a two-day case of dehydration that couldn’t be relieved by drinking fluids, followed by a kidney stone that developed ten days later.

I am one ileostomate who has always ignored those warnings. I donate blood regularly and haven’t suffered any ill effects. My object in this article is to examine this topic rationally, instead of relying on an anecdote that may be more of an urban myth than an actual event. My conclusion is that most ostomates can probably donate blood without any problem although, if you’ve just had surgery, you may need to wait a while (for example, you may not be eligible to give blood until a year after surgery).

Of course, all ostomates are different, and may have a variety of health problems in addition to the ostomy itself, so it isn’t possible to make a blanket statement for all ostomates. Therefore, you should check with your doctor if you have any doubts about your ability to give blood.

The question in the title of this article involves two issues: Is giving blood safe for the ostomate? And will the ostomate’s blood be accepted by the blood bank? In researching these issues, I’ve spoken with the head nurse at my local Red Cross blood collection center, and I’ve checked the eligibility guidelines on the American Red Cross website at www.redcrossblood.org. It should also be noted that rules for donating blood vary in different countries. My comments on this issue apply mainly to the United States, where the rules are set by the U.S. Food and Drug Administration. Readers in other countries need to check the rules in their country.

As for myself: When I wrote the first version of this article in Aug 2006, my lifetime total consisted of 79 (whole) blood donations. Now, as of Feb 2009, I’ve given whole blood 83 times and I’ve also done 4 double red blood cell (2RBC) donations. Most of my donations have been made after my permanent ileostomy surgery, which was done in 1992. Prior to that, I donated at least 5 times during the 4 years while I had a J-pouch (my J-pouch failed due to chronic pouchitis and was then replaced by a permanent ileostomy). Before that, I even donated a few times while I had ulcerative colitis, although only during the first few years of the disease, while it was still controlled fairly well.

On the first question, whether giving blood is safe for the ostomate: Dehydration can certainly be a valid issue, especially for ileostomates and others who have lost their colon (including people with J-pouches and Kock pouches), because the colon normally plays a role in absorbing water. Urostomates also need to remain well hydrated to maintain urinary health. Therefore, all of these ostomates should drink extra fluids to stay well hydrated.

Dehydration was the villain in the “horror story” cited at the beginning of this article. Severe dehydration can result from various causes, such as an ileostomy blockage or acute gastro-enteritis accompanied by vomiting and diarrhea. By comparison, the dehydration resulting from a blood donation is relatively minor. The quantity of fluid removed (about half a liter, or about one pint) is far less than you’d lose in an acute blockage or gastro-enteritis episode. So, if you’re careful to hydrate well before coming to the blood collection center, then drink all fluid offered to you at the center, and then continue to drink lots of fluid afterward, you probably won’t have any problem with dehydration. Even so, if you think you’re prone to kidney stones, or if you have any other concerns about the safety of giving blood, check with your doctor.

Meanwhile, if you’re still concerned about dehydration, another option is available now, namely, the newer “apheresis” donations. These are procedures in which components of your blood are separated by specialized equipment while you donate, and some of these components are returned to your body. I’ve been donating with one of these methods, namely, double red blood cell (2RBC) apheresis, for over a year. In this technique, a double unit of red cells (twice as many as in a normal donation) are taken, but everything else (including the plasma) is returned. And in addition, enough saline is pumped into your body to compensate for the volume of cells removed. In this way, there is no net loss of fluid, and assuming you also drink something at the blood collection center, your fluid level when you leave the center will probably be higher than when you arrived!

As a result, these 2RBC donations do not cause any dehydration. And, in spite of losing a double unit of red cells, you may not feel any of the tiredness afterwards that you might experience after a regular blood donation. It should be noted that the specialized equipment required for these apheresis donations isn’t available at all local blood collection centers. Also, to be eligible for the 2RBC procedure, your hemoglobin (iron) level needs to be somewhat higher than for a normal blood donation.

Now, let’s consider the second question, whether the ostomate’s blood will be accepted: Before donating, you’ll need to answer a list of questions (the donor history questionnaire), which seems to grow longer every time you donate. You should find, however, that none of the questions require mentioning that you’re an ostomate. Having an ostomy does not (at least in the United States) disqualify you from giving blood. And if any worker at a collection center tries to tell you otherwise, that person is misinformed.

The questions you’ll need to answer refer to specific conditions that may make your blood unsafe to give to another person. Some conditions (which generally have nothing to do with having an ostomy) can disqualify you permanently. Some may require you to wait for a period of time before giving blood. If you’ve just had surgery within the past year, especially if you received a blood transfusion during that surgery, you probably won’t be eligible until a year after the surgery.

An important special case involves surgery for cancer. As we know, many ostomies are done because of bowel or bladder cancer. When I wrote the first version of this article in 2006, most cancers required a waiting period of 5 years. Now, that waiting period has been reduced to one year. Current guidelines on the American Red Cross website say, “Eligibility depends on the type of cancer and treatment history. If you had leukemia or lymphoma, including Hodgkin’s Disease and other cancers of the blood, you are not eligible to donate. Other types of cancer are acceptable if the cancer has been treated successfully and it has been more than 12 months since treatment was completed and there has been no cancer recurrence in this time. Lower risk in-situ cancers including squamous or basal cell cancers of the skin that have been completely removed do not require a 12 month waiting period.”

If you currently have a chronic disease such as Crohn’s disease or ulcerative colitis, you’re probably eligible to give blood. Remember: I actually donated a few times while I had ulcerative colitis. On this topic, the Red Cross guidelines say: “Most chronic illnesses are acceptable as long as you feel well, the condition is under good control, you have an adequate hemoglobin level and your temperature is normal when you come to donate, and you meet all other eligibility requirements.”

In conclusion, most ostomates are probably eligible to give blood, although you may face a waiting period if you had surgery very recently. You may, of course, have other health conditions that make you ineligible. But it can’t hurt to try! At the collection center, medical professionals will review your health information, in a confidential setting, to determine if you are actually eligible.

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