Australian Red Cross Blood Service

This page describes the principles under which the Australian Red Cross Blood Service (Blood Service) will offer a Therapeutic venesection programme and the rationale for our recommendations.

Some of our Blood Service centres provide a therapeutic whole blood venesection service for patients with medical conditions where regular venesection is beneficial. We offer this service for the benefit of individuals referred by treating clinicians.

The final decision as to the suitability and acceptance of individuals to be venesected remains with the Blood Service.

Blood Service requirements for Therapeutic venesection

1. The therapeutic venesection service is offered to individuals with medical conditions where regular venesection has been shown to be beneficial [eg, haemachromatosis, polycythaemia (rubra) vera, porphyria cutanea tarda]. The individual must not have a transfusion transmissible disease.

   • Individuals must satisfy the following criteria:

     • have a recognised genetic predisposition to iron overload in the way of homozygosity or compound heterozygosity for the known haemochromatosis genetic mutations; or

     • have biochemical evidence of iron overload (elevated transferrin saturation with or without elevated ferritin) in the absence of other disease; or

     • are referred by a specialist who has assessed the patient as requiring therapeutic venesection.

2. Individuals with an isolated ferritin only, who do not fulfil the above criteria, would need to be assessed for suitability for routine whole blood donation by a Blood Service Medical Officer.

3. The blood collection will be used in clinical or plasma-derived products only if individuals fully meet the donor selection guidelines for clinical use.

4. The referring doctor is ultimately responsible for clinical management and will review the ongoing need for venesection every 12 months or as often as specified by the referring doctor. The Blood Service will not be responsible if individuals do not attend for venesection.

5. The Blood Service is responsible for therapeutic collection, and the care and safety of individuals during the venesection procedure.

6. Once an individual has been accepted into the therapeutic program, he or she will not be deferred on the basis that the individual’s blood is not suitable for transfusion or the manufacture of plasma-derived products. This is to encourage risk factors to be disclosed in a non-discriminatory process so that the safety of the blood supply is not compromised.

7. Individuals with haemochromatosis who have been suitably ‘de-ironed’ may donate at the same frequency as whole blood donors without the need for the 12-monthly review, subject to the approval of the treating doctor.

For further information about the Therapeutic venesection programme, please call 13 14 95 and ask to speak to a Blood Service Medical Officer.